1 November 2017

Professional, confidential, friendly counselling in central Exeter


Serious about making changes in your life?

If you are looking for a therapist you have taken a courageous first step. Life can be hard for us all at times.  I love the work I do; helping people to explore what's troubling them in order to live more fulfilling lives.

I work privately from beautiful premises on Southernhay, right in
the centre of Exeter, Devon, with a wide spectrum of people with many differing presenting issues. Professional, approachable, open-minded and non-judgmental, I have the utmost respect for my client's individuality and life circumstances. 

I draw from several reputable theories of practice enabling me to work effectively, progressively and collaboratively with individuals and couples.

Offering a fully professional service I am fortunate enough to be able to work full-time at my dedicated Exeter practice, seeing clients five days a week. 

I am committed to facilitating the exploration of the issues you bring. If you are serious about committing the time and energy required I invite you to make contact to arrange an initial appointment.



Click here for Contact and Cost Details


 PLEASE NOTE THAT THERE IS A WAITING LIST FOR ALL TIME SLOTS. NO EVENING SESSIONS ARE AVAILABLE FOR THE FORESEEABLE FUTURE


This site is where you can find out information about counselling, my personal approach and services offered, and some details about my background, by clicking on the information tabs above. 

This is also a blogsite which I use to make regular posts about my work and continuing professional development as a counsellor. Click here for my Articles.

I would be very happy to discuss your requirements should you be interested in coming along for counselling. Embarking on a course of counselling can be daunting and I aim to help you feel relaxed and confident that you make the choice that is right for you.

Regulation 


Please, whoever you decide to have counselling with,  whether individual or agency, ensure that they are registered with an adequate professional body. The BACP is the largest professional body and have a robust complaints procedure which is why I choose to be registered with them. BACP Accredited status is an established, recognised and accepted assurance of experience and maturity as a practitioner. Without membership of a self-regulating professional body then clients have no recourse should they feel that they are being treated unethically. At the moment, there is nothing to stop people practising as counsellors without this protection for their clients. Following the dreadful scandal involving the Exeter based Palace Gate Counselling Service I researched and wrote about this topic on this post about the regulation of counselling and psychotherapy

I campaign for the regulation of counselling and psychotherapy along with Phil Dore via the website Unsafe Spaces



30 August 2017

Therapists and holidays



I write this a week after returning from two weeks annual leave. I have been wondering whether it might be an idea to give newer clients a hand-out to read prior to planned breaks so that they have a idea of how a therapist having a break might impact on a client. Most clients do not appear to be adversely affected by my having time off and I always do my absolute best to give as much notice as possible. Some clients value having a bit of a breather. However, during any holiday I take, some clients might be impacted negatively and although it might seem clear that clients with attachment issues and complex trauma would have more chance of being impacted, it is not always obvious to me who might be affected and in what way. It might not even be clear to a client that they are being impacted by their therapist's absence so open and honest dialogue is important and, on the part of the therapist, an awareness of this being a possibility.

Occasionally, a client might be so impacted that they withdraw from therapy completely without giving themselves the chance to learn and grow from the experience. I would venture to say that of the few clients that have disengaged from therapy without prior discussion this is more likely to happen following my absence. Of course this might be that time out from therapy has given the client enough space to decide that it doesn't seen to working for them but I strongly suspect that this is not always the case.


The importance of self-care for therapists


I very much value and enjoy the work I do but it can sometimes be emotionally depleting, especially if one is a busy, full time therapist and/or if dealing with serious trauma work. Taking time out from being a therapist is paramount for many reasons:

Avoiding burn-out - a therapist with burn-out who then has to take time off with stress might result in unplanned breaks which for clients are almost always much harder to deal with than planned breaks.

To regain a healthy perspective - this is particularly true when dealing with issues such as childhood sexual abuse and complex trauma. These are areas where even the most positive thinking therapist might start to view the world with a somewhat negative outlook, finding ourselves immersed in the darker side of what human beings are capable of. This can be one of the warning signs of burn-out and a reason why self-aware therapists will cap the amount of trauma work they take on as well as taking adequate breaks.

To spend quality time with friends/partners/children/family - important for almost all people, no matter what their job or lifestyle.

To have some alone time - also important for most people, perhaps particularly for the more introverted therapist *holds hand up*.

Modelling self-care - how can we expect clients to learn to value themselves and honour their personal requirements for self-care if we don't do the same by not taking adequate breaks?

Taking time out for other work related tasks - as a self-emplyed therapist I run my own business, update my own website and social media accounts, do my accounts and like all therapists, regularly engage in Continuing Professional Development such as workshops, reading, research and occasionally writing articles such as this. Due to my working full-time and having family commitments, I do not have much spare time to catch up on the admin side of the role.

I asked for therapists and people who are/have been in therapy to share any comments they had about the topic.

Comments from other therapists via my Twitter post







A therapy client's point of view (sent via my Facebook page)

I was kindly sent the following by somebody in therapy in response to my question about the impact of holidays:



I've seen many therapists and a flash point for me is always when they have long breaks e.g. the summer holidays etc. Although I am completely aware that all good therapists need to have breaks and look after themselves I find it so hard to reconnect with them after a break and this is often the time I chose to bail on them and not return to sessions. I find it very hard to bond with people, especially professionals, and find that a long break just makes me shut down and then I don't want to go back. Want is probably not the best choice of word.

The first time my current therapist, who is by far the best I've seen, was going to have a month off for summer she said 'While I'm on holiday can I ask you...' and I finished her sentence 'Can you ask me not to contact you as you need family time, you are a professional with boundaries etc' and I had that sinking feeling that it was all about to go wrong for me. But to my surprise she said 'Nope, can I ask you that if shit and fan collide please get in touch and we can have some communication?'.  Because she had said that I didn't freak out, feel trapped,  or indeed contact her, I think because I knew I could and I didn't feel rejected.

During the Christmas break I miscarried my IVF baby and I emailed her and we did meet up, her suggestion not mine, and that was so helpful. I know if we hadn't been able to I wouldn't have been ok about continuing sessions after Christmas.

I do completely understand therapists need holidays and breaks and probably need more than most! Clients, me included, can be very selfish and see long breaks as rejection or as a wobble in therapy and previous to my current therapist I couldn't then reconnect with them as they had laid down tight professional boundaries which were inflexible and made me feel 'controlled'.

Therapy is so intense , I see mine twice a week, and a break of a month is eight sessions and that seems insurmountable when you're in a mess!

Somebody else commented:

I really appreciate and value that my counsellor takes around a month off in the summer. Showing her commitment to self care and always well prepared for.


So as therapists it is important that we:



  • Take adequate breaks from the work
  • Give as much notice as possible to clients about breaks
  • Be aware of the potential impact of our breaks and introduce a discussion with our clients around the topic before and after


And for clients:



  •  Be aware that it is normal to be impacted by breaks so don't judge yourself negatively
  •  Bring any uncomfortable feelings about breaks to your therapist. If you don't feel able to talk about this with your therapist then maybe this isn't the right therapist for you
  • A good therapist will welcome discussion around any impact on you. It can be a valuable part of your process, particularly if you have struggles around trust, attachment or abandonment.

Please leave your thoughts in a comment below. I value feedback and we can all learn from each other.




12 March 2017

Recently published article on trauma work on counselling and psychotherapy

I used to blog so much more regularly however since working full-time as a private therapist (I went to 5 days a week in January 2015) I have had very little time for writing. Along with a busy life outside of work and campaigning for regulation of counselling and psychotherapy I often have topics I would like to write about...if I had the time...but, well...

Last year saw the important publishing of the Unsafe Spaces report which I co-authored along with Phil Dore* my fellow campaigner. Finding the time to focus on this was difficult but it is very important to me to contribute to discussion within the profession.

Then a few months ago I was invited by the online magazine The Counsellors Cafe to write an article. Having spent several months prior to that thinking about writing something about the difficulties of working with trauma I decided to use this opportunity to focus on producing something to get some of my concerns out there. So I finally got my act together and started to work on a piece which was published on 10th March entitled Care When Working With Trauma (click to take you directly to the article).

I had a few factors that had motivated me to write such a piece:



  1. Working directly with clients who have been abruptly dropped by a therapist and hearing accounts from service users in general about feeling abandoned when therapy is suddenly terminated with no warning or ending.
  2. My own journey of learning more about trauma from reading books by Babette Rothschild and Bessel Van Der Kolk and attending specialist trauma workshops such as those run by Positive Outcomes for Dissociative Disorders. I realised that there were gaps in my core training. 
  3. The realisation that a few years ago, when my therapist had to end sessions with me it was emotionally difficult, even though there were very good, ethical reasons for doing so.
  4. Hearing and reading various comments on counsellors forums which quite frankly have greatly concerned me about the competence of some practising therapists. 

Like anything I write, I reflected and immediately wished I had included more. I see this piece as work in progress and I have further work to do. I do believe that there is insufficient training in a lot of basic counsellor training and that there is a danger that therapists can unwittingly retraumatise their clients.

I've had some great feedback from other therapists who share similar concerns. I have done some research on whether qualified therapists believe their core training equipped them sufficiently for working with trauma. The findings were as I suspected; many did not feel that their training was enough. I just need to find an idle moment to make contact with some of the professional bodies who accredit training courses and see what their opinions are. Then bring it all together in a compelling article. It will likely take me while!

I don't want to put people off accessing therapy but I do believe that forewarned is forearmed and that as professionals we should be striving to improve our profession and keep it as safe as possible for our service users.

The work I value most is my working directly with my clients but the bigger picture of the profession is also very important to me.




*two days ago I received an official comment from the Professional Standards Authority on our report, requested on our behalf by Ben Bradshaw MP (my local MP and a member of the Health Select Committee). We are still awaiting as response from Jeremy Hunt.

31 December 2016

A framework for New Years Resolutions?



I wonder how many people are setting themselves some resolutions this year? What is the drive behind the choices they make? Are people attempting to make changes because they are critical of themselves? "I'm too (insert word here)", "I'm not (insert word here) enough", "I should/shouldn't be (insert word here)"?

How about a framework for making resolutions?           

How about basing the choices you make on something fundamentally meaningful?

I propose that Bronnie Ware's famous list of "Top 5 Regrets of the Dying" could be a great way of defining resolutions that will ultimately make a difference to the quality of our lives. Bonnie has shared what she discovered as a nurse in palliative care. Her findings, which she has extended into a book on the subject, are as follows:


1. I wish I’d had the courage to live a life true to myself, not the life others expected of me.
This was the most common regret of all. When people realise that their life is almost over and look back clearly on it, it is easy to see how many dreams have gone unfulfilled. Most people had not honoured even a half of their dreams and had to die knowing that it was due to choices they had made, or not made.
It is very important to try and honour at least some of your dreams along the way. From the moment that you lose your health, it is too late. Health brings a freedom very few realise, until they no longer have it.
2. I wish I didn’t work so hard.
This came from every male patient that I nursed. They missed their children’s youth and their partner’s companionship. Women also spoke of this regret. But as most were from an older generation, many of the female patients had not been breadwinners. All of the men I nursed deeply regretted spending so much of their lives on the treadmill of a work existence.
By simplifying your lifestyle and making conscious choices along the way, it is possible to not need the income that you think you do. And by creating more space in your life, you become happier and more open to new opportunities, ones more suited to your new lifestyle.
3. I wish I’d had the courage to express my feelings.
Many people suppressed their feelings in order to keep peace with others. As a result, they settled for a mediocre existence and never became who they were truly capable of becoming. Many developed illnesses relating to the bitterness and resentment they carried as a result.
We cannot control the reactions of others. However, although people may initially react when you change the way you are by speaking honestly, in the end it raises the relationship to a whole new and healthier level. Either that or it releases the unhealthy relationship from your life. Either way, you win.
4. I wish I had stayed in touch with my friends.
Often they would not truly realise the full benefits of old friends until their dying weeks and it was not always possible to track them down. Many had become so caught up in their own lives that they had let golden friendships slip by over the years. There were many deep regrets about not giving friendships the time and effort that they deserved. Everyone misses their friends when they are dying.
5. I wish that I had let myself be happier.
This is a surprisingly common one. Many did not realise until the end that happiness is a choice. They had stayed stuck in old patterns and habits. The so-called ‘comfort’ of familiarity overflowed into their emotions, as well as their physical lives. Fear of change had them pretending to others, and to their selves, that they were content. When deep within, they longed to laugh properly and have silliness in their life again.
(NB This list is taken from Bronnie Ware's site)
So how might a list of resolutions look using this as a framework?
1) Make a list of things you want to do in life and plan roughly when those things can be achieved. Make one of those things happen this year.
2) Find a better work/life balance. Try a session or two with a counsellor or life coach or read a book on the subject. Watch some Alan Watts lectures. Here's a great one.
3) Find a way to be able to express your feelings. Confide in friends. If you struggle to express yourself then try some sessions with a counsellor to learn how to express your feelings. We all have them. We haven't all had the opportunity to learn how to express them.
4) Dig out your old address book and make contact with people you stopped sending Christmas cards to years ago. Or look at those that you send a quick one-liner to and write an actual letter. Arrange to meet up with at least one old friend this year.
5) Allow yourself to experience happiness. If guilt or shame are getting in the way then find a therapist to work through those feelings. Everyone is entitled to feel joy. Find something joyful that you can do this year. Join a group, buy yourself something silly but fun. This doesn't have to be expensive. I got a lot of joy out of buying an old copy of Ladybird Cinderella which I absolutely loved as a kid. It was a few pounds on eBay. I still drool over the three frocks she got to wear in that edition.
Final note
I do not want to make light of the real struggles that some people face and loss, poverty and ill health as well as discrimination can have a very negative impact on our experience of life. This article is meant to highlight those things that we potentially do have a choice in, although not all of us will be able to make those choices. I remain sensitive to that.



30 December 2016

Top 5 Lifestyle Tips - Things to do Alongside Counselling



(Originally published 7th August 2013)

Counselling is usually for one hour, once a week, for a set duration. That leaves a lot of time spent outside of the counselling room, with the issues that brought a client there perhaps not changing an awful lot between sessions. So I sometimes advise on what steps a client can take to assist the counselling work and help them achieve their goal of overcoming grief, depression, unwanted patterns of behaviour or relationship issues.

1. Take up Meditation

The West is catching up with what the East have known for millenia. Meditation is good for the mind, body and soul. Pretty much everybody has heard of meditation but in the past it has had an air of hippiness or religiousness about it, but even the NHS has caught onto the benefits with the Western-friendly concept of mindfulness (click here for an interesting post exploring the differences/overlaps between meditation and mindfulness).

Here is a short video done by a chap called davidji who succinctly and quite persuasively explains some of the benefits of meditation in this short (2:15min) video (click here if it does not show up on your device):



If you need any more persuasion, try this link from The New York Times regarding research in meditation and how it effects the brain. 

You can start off by trying a guided meditation CD or looking on YouTube for a taster. 

2. Keep a Journal

Keeping a personal journal was a requirement of my training. We had to bring in our journals from time to time to show the tutor that we were writing in them regularly. I really learnt the benefits firsthand of writing down parts of my process. There are a few reasons for why it was so useful:


  • Expressing frustrations without offending anybody
  • Consolidating work done in personal therapy (another requirement of my training)
  • Being able to look back and chart personal growth
  • For visual learners - reinforcing what you have learnt 


Some of my clients keep a journal and write reflectively in between sessions. Sometimes, they might bring some of their thoughts to the next session. There are no rules about what's right or wrong in this respect - each person is different. What I can say though, is that those that keep journals tend to need less sessions overall. This is a hard thing to quantify, but it seems to me that the work is more "efficient" and it keeps us more on track if the client does this work between sessions.

Making a note of any dreams can create fruitful work too. It is quite common for clients to have a highly symbolic and powerful dream the night before a session.

3. Take up some aerobic exercise 

Exercise raises endorphin levels in the brain. Endorphins contribute to our sense of well being, as well as being natural painkillers. Regular exercise will help you to feel fitter and help you get into shape, to feel healthier and better about yourself. Read this NHS article for more information on the relationship between exercise and depression. I wouldn't go so far as to say that exercise can cure depression, but it can help alleviate the symptoms by letting the body access it's natural, feel good hormones.

Aerobic exercise is the kind that gets you out of breath, so walking would need to be to the point that you struggle to speak and get sweaty. Swimming would need to be pushing your limits. Running and strenuous sports such as tennis and squash would count as aerobic exercise, as well as many cardio-based gym classes.

4. Take up yoga, pilates or martial arts

Although these are also described as exercises, I have separated them from aerobic exercise because the benefits are different (although strenuous yoga or martial arts will yield cardio benefits too). The benefits of these forms of exercise are that they strengthen the mind and body connection. These activities require a lot of learning, so the challenge is mental as well as physical. By doing these kinds of activities you can create the space to make changes in areas of your life where you are struggling. It is easier to break old habits if you harness your brain's ability to reshape it's neuronal networks by contunued learning. Joe Dispenza writes extensively about this in his book Evolve Your Brain, which I write about here, along with the reasons why I began to learn a martial art.

5. Pay attention to diet

I am not a nutritionist but I have long been interested in dietary matters. I believe that many people would feel a lot better if they had a dietary overhaul. Sometimes, I enquire about food habits with clients as a poor diet can lead to mood swings, difficulties with sleeping and the worsening of the symptoms of depression, anxiety, the menopause and pre-menstrual tension.

I have had a few clients give up caffeine, or at least cut down, because caffeine can induce anxiety in some people, and cause insomnia in others. Alcohol can lead to depression and anxiety the day following consumption. Many people do not realise the connection between what they eat and their subsequent mood. A food diary can help.

An interesting book to read on the subject is Patrick Holford's The Optimum Nutrition Bible. If you can get half way to eating the way he suggests you'll probably feel a whole lot better.

Amanda Williamson is  BACP Registered private counsellor working in Exeter, Devon. 

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