25 November 2013

On Working with Boarding School Survivors

By Amanda Williamson, Counselling in Exeter

Boarding school survivors?

To whom does this term apply? Would that be anybody who went to boarding school and was abused? Is it anybody who went to boarding school and was distressed at being separated from the family and home? Does it refer to everybody who went to boarding school?

The term has emotive and probably contentious connotations so I shall proceed with referring to those that attended boarding school as ex-boarders. The workshop I attended referred to the subject matter as "The Boarding School Experience" and was run by local counsellor/psychotherapist Jane Barclay, herself an ex-boarder and a director of Boarding Concern.

I was keen to go and learn more about the boarding school experience as I have worked with some ex-boarders. Certainly, I have found anecdotally that the impact of that particular education format has left an undeniable impact on some in respect of self-esteem, the insistence of denying vulnerability and/or having difficulties with intimacy (all intertwined).

I attended the workshop with an open-mind. I have never set foot inside a boarding school. I had my prejudices and sketchy preconceptions based on Enid Blyton books (sardine sandwiches and ginger beer at midnight). I was interested to hear about ex-boarders' insights and really learn about their experiences.

Of the 12 delegates, all of whom were either qualified, or trainee counsellors, 3 of us had not attended boarding school. Of the remainder, all had had a negative experience, apart from one who had had a very positive experience. It was agreed that it was good to have the presence of somebody who had had a positive experience to add perspective to the emotive topic.

The workshop was held over 2 days, split by a 5 week interval. The first day we looked at how a child might adapt to the boarding school existence and how they might construct a Strategic Survival Personality. This consist of the ways of coping with the separation from home and family at an early age. The child identifies with power and independence and disowns their vulnerability and dependence.  This way of existing then continues on into adult life.

We then watched a video of a documentary by the BBC in 1994 called "The Making of Them". It was watching this that evoked a very strong emotional response in me. I was so overwhelmed by what I saw that I fought tears. I struggled with my own perception of the parent-child bond and how my intuition informs me. Keeping an open mind became more and more unmanageable. The documentary itself is about a number of young boys and watches them and their families as they are sent off to boarding school. We see some of them blatantly suffering emotionally, and others, more stoic, and "grown-up" and having already started the construction of a Strategic Survival Personality. There were many poignant moments. One was when you see one of the mothers at home, denying any hurt that her son may be encountering, stating how good for him the experience is, whilst dotingly stroking the pet dog planted firmly on her lap. Also, one of the stoic little boys, convincing us (or himself?) at how good it is to be so grown up, just like an adult...then proceeds to talk about the red clown nose on his birthday cake in a manner completely befitting of a very young child, juxtaposing what he is telling himself and the reality of his vulnerability.

Afterwards, we split into groups to discuss the film and how we noticed how the children and parents managed their feelings. I burst into tears, and felt an utter fraud. I never went to boarding school. How could I find this so upsetting? This is something I struggled with for a week or so, and went on to examine - what is going on for me in all this? On the one hand, I want to retain a genuinely open mind and not judge the experience of any ex-boarder. Yet there I was having a very passionate response. Every cell of my body was screaming to me that it is wrong to send away a precious child to a school where yes, they may be looked after well, and have a great education and lots of friends (although many delegates at the workshop did not have such experiences), but, WHERE IS THE LOVE?

By the second day, 5 weeks on, I had calmed down quite a bit. We shared our journeys since the last workshop, and most people had had interesting and powerful process.

We talked more about the Strategic Survival Personality and how this translates to character traits, about how difficult it can be to change those traits, about examining whether they are appropriate or helpful traits in adulthood.

We looked at how the young child might learn to deal with the separation, and and what they might be missing out on in being sent away from the home. We also looked extensively at the older boarder, the one who is sent away at age 13, and the effects of being sent away by their parents, the development of sexuality without the safety of flirtation with the opposite sex parent (not restricted to boarders of course).

Throughout the course, I recognised elements of my convent grammar school education in some of the criticisms of the boarding schools. I was not a boarder, but I was affected by a heavily Catholic flavour to the education process. Sanitary towels were bricks that we pinned to our underwear. Our uniforms were the most unflattering, sexuality-repressing garments imaginable (long a-line skirt and deck-chair blazer and faun socks - gorgeous!). The nuns were cold and sometimes cruel. I could identify with some of the issues that the ex-boarders had to face.

Most of all though, I realised that the fact that my mother left the family when I was 13 meant that there were parallels between my experience and that of female boarders sent to board at the same age. Perhaps I was there for this subconscious reason.

Working with Ex-Boarders

So how about working with ex-boarders? Well, much like my GamCare training, which was not about "which technique to use with people with gambling issues", this course was not about "how to counsel ex boarders". The intention, as far as I am aware, was to equip us with insights and awareness around the potential issues that may be relevant to working with this issue. This was very much accomplished.

After the workshop I feel that I have gained wisdom around the issues, rather than information and techniques. Wisdom is so much easier to integrate into the counselling process.

Amanda Williamson Reg MBACP - Counselling in Exeter

Amanda Williamson in a counsellor working in Central Exeter. Please click here for more information.

14 October 2013

Video game Addiction or Poor Time Management?

By Amanda Williamson - Counselling in Exeter

I've been doing a bit of pondering since reading a few weeks ago about the release of Grand Theft Auto 5 and the anticipated endemic of "sickies" as a result of it's release.

I grew up with 4 brothers and a sister, in the 70's and early 80's. Early childhood was about going to the park by ourselves, playing in the garden, waiting to watch the tiny bit of kid's television that was on during allocated slots, and playing with an assortment of plastic and wooden toys. I recall the excitement of one year, receiving both of my either/or Christmas gifts selections - a Bontempi Organ and a Girl's World styling head! (I think that every Christmas has been an anti-climax since then). Hour upon hour of teaching myself to play "Puff the Magic Dragon" on the organ, and how to plait plastic platinum blonde hair...

The first opportunity at video gaming was of course, Pong. I think I first saw it at my Grandparent's house - my uncle is only 4 years older than me so I suspect it was his, although my Nanna was always a bit of a technophile. Of course it's hard to look back in retrospect and fully appreciate just how much fun this rudimentary game was. To the younger readers; believe me it was fun (see the scintillating game of tennis to the right). 

Then one Christmas, when I was around 9 years old, we received a joint Christmas present of an Atari 2600 along with Space Invaders, Pacman, Defender and Asteroids. Wow! We were in gaming heaven (honestly!). Shame we had to take turns with 5 of us (little sis was too young at that stage). Space Invaders was the best, and we worked out a "cheat", by pressing "reset" at the same time as switching it on, which resulted in being able to shoot out non-stop bullets, rather than waiting until the previously fired shot had reached the top of the screen. We busted some records big time with that cheat!

By adolescence I had discovered things outside of the house to keep me occupied, and my gaming stopped. It didn't really pick up again until when I was about 20 and I got myself a vintage Tomy Tronic for a boost of childhood fun, followed by a Nintendo GameBoy when I was about 24. My partner at the time was anti-gaming, so it was a solitary pursuit. Then I had kids, and there wasn't time for such frivolities. I guess you could say that I am hardly a gaming addict then.

These days, I only really like playing games that are so ridiculous, that don't in any way attempt to simulate real life. We're talking MarioKart, Rayman's Raving Rabbids, Wii games, that kind of thing. By the way, this may have something to do with a phenomenon which is currently being researched, that is, the mechanics by which many of us find virtual humans unsettling to look at, known as Uncanny Valley. I can tell even the most HD digital imagery from analog, so I think I am sensitive that way.

But this is really about whether gaming can be problematic, or even addictive, although I have enjoyed a trip down memory lane...

Does video game addiction exist?

Is there such a thing a video game addiction? Is it problematic? Or is it just hysteria. It certainly seems to be a highly emotive topic with people taking quite strong views either way. Here is a interesting paper entitled Problems with the Concept of Video Game "Addiction"  (link broken as of Jan 2024) which seems like a quite balanced and rational sounding argument that there is a lack of scientific evidence to their being such a thing as video game addiction. The case studies involved, by self-professed gaming addicts, seem to involve more of an issues with poor time management and prioritising than of addiction per se.

There also this post on the site Fit Family Together which has a strong opinion on the effects of video games on children. (link now obselete as of Jan 2024). There are some particularly interesting and rational comments on the post, in contrast to the usual trolling that seems to take place on any post expressing opinion.

What do others think?

So I put it out into the social networking world - does anybody have anything to say about video game addiction, or their experience of it? I'm not interested in jumping to conclusions about how addictive and harmful gaming is (although I have been tempted on occasion) so I really wanted to get some level-headed responses from gamers.

Well, one of my brothers responded thus:

"I'd take up too much of your time - I wouldn't know where to begin!!

Does this mean that it is more of a time management issue or an addiction?!

Another of my brothers, Ross (pictured with me above), 40, busy running his own business and raising two young children, offered the following:

"Back in the early 90's as I was locked into the virtual world of Amiga gaming. I have found myself cured nowadays and although an owner of a PS3 and Wii I only ever spend about 20mins per week overall. Video game addiction back in the early 90's was mine and my other brothers' escape from the boredom at that time and as I was not educated very well it took me into a world where visuals and sound would move me in the safety of my own bedroom. It felt wonderful at the time and gave me the release and maybe stimulation one required as a bored teenager that craved input in the mad world around oneself at that time. It's kind of like a drug in a way and one that can sap the life out of you if you choose to stay embedded within that lifestyle- luckily for me it was a phase I was going through but still to this day I find myself invigorated occasionally to play video games and really get lost within the world although I'm older and wiser so now know when to say goodbye rather then spend the wee small hours trying to crack a level or score a winning goal."

I also received the following message from Ben, who has a girlfriend, a responsible job and no kids:

"I don't think my addiction causes me true issues in life or relationships. Both me and the missus are gamers, geeks. We actually met through WoW. So sometimes that's a positive. But I do think that giving so much of your time and energy to something which is supposedly "fun" can make the game a job. I used to do "proper raiding" - pushing for content clearing, dungeons and such, but trying to get there before others. We weren't like the professional gamers, but did raid 4 days a week, 3 to 4 hours a time. With a group of between 25 and 10 people, each with roles and responsibilities, it was a job... but rewarding. However the rewards are fleeting. There is always something "else" to get to. new content, new things. The game (WoW) can't ever be "beaten" as new expansions or patches add new challenges. And that's a definite feed for the drug like aspects. I know I've let past relationships falter because of the game (I "had" to attend X, Y and Z dates every week). I know I've not met "real life" friends for that impromptu drink or catch up, because of something I "had" to get prepared for in the game.
But that was definitely in the past. The game has changed for me, and I take it much more as something interactive to do with a group of people who I do think of as "true friends". I've met most if not all of our guild, in real life. I've travelled around to see them in Europe and the UK. And that's a definite positive. I'd rather sit and play a game for an few hours and chat with people whilst doing it, than sit vegged in front of the TV on the sofa. A game might just be a game, but it can stimulate your mind in ways that TV pap doesn't.
I have chosen to "escape to games" before. It's easy, you are in control of something, where in "real life" you might feel you've lost control. Your character doesn't have to show fear, your avatar can be things you wouldn't be, or couldn't be (and I don't mean engaging in "horrible acts" or strange sexual forays - though I do know both are done). It's in moments like those, looking back, that I think it's definitely an addiction. Like turning to booze or drugs (and I've done both of those before). But it has for me been much less destructive than other drugs. I've gained much more than I have lost."
Here are some words from Brian, a married, working man with three kids:
"Looking back on it, gaming was probably problematic for me for around 10 years, between the ages of 15 and 25. I started gaming when I was age 11. By 15 gaming turned into a social impairment - friends would come around and we would just game rather than interact - gaming became more primary than socialising. At the time I regarded it as a cure for boredom; instant fun. I would play for 2 hours a day after school, and 4 or 5 hours a day at the weekend.
By age 25 I realised that gaming was a hindrance to my development as a person. I felt a bit stuck with it. I had done a Myers-Briggs personality test and it highlighted that addiction might be an issue issue for me. Sometimes I managed to give gaming up for a week, but then would return back to my old habits.

For me, the short term benefits of gaming are:
  • that it gives me a buzz
  • it activates a lot of my brain - I get a chemical hit
  • there is some amazing storytelling in gaming, particularly in recent developments
  • it's fantasy
  • I enjoy problem solving - gaming can be like a puzzle
However, there are drawbacks, and for me, I would say that the main short term drawbacks are that gaming is a distraction from responsibilities, and a distraction from my goals. In the long term, gaming is a distraction from personal development and from long term life goals.

Nowadays I have my gaming where I want it, I can pick it up and enjoy the escape, but I am still able to focus on my responsibilities and goals"

Louis is a 14 year old boy who shares his foray into gaming and how it has taught him some things about himself, and how it has affected his attitude to certain aspects of life such as competitiveness:

"For a large part of my early childhood, gaming was not a thing.  We first got a console when I was about 8 or 9 years old. For me and my brother, gaming was mainly a co-operative thing to us, and I think part of the reason that we enjoyed it was because of the fact that we were both pretty much just as good at it as one another. Due to lack of the practice, it was one of the few things I couldn’t do better than my little brother.

But that didn’t last long, as we soon realised that it was more fun to destroy one another in games, rather than do boring co-operative work. I believe that the reason for this is that spending so much time with one another we had a lot of frustration, but with physical Lego structures or drawings, there was no way to bring suffering without actually doing damage to something, but this was no such problem with video games.

To us, video games were a way that we could play together without making a mess or breaking anything, and also a way to do things to one another that we could never do in real life. (i.e. killing). For a while it was also a fun challenge, and we had plenty of fun with that , but then came the problem that when we lost it wasn’t good. Losing meant that we had to try again, and this was frustrating and time consuming, mainly because we were obsessed with doing it well. Video games brought out our competitive sides, against one another and the AI, and we got angry at the game a lot. This was the peak of the addiction, and it wasn’t always fun.

I think this stopped because of a certain game: Banjo Kazooie Nuts & Bolts, that was very free-reign and not taken seriously. It involved creativity mixed with practicality, and a universal enemy for the two of us, but the thing that made it so special to us is the fact that winning wasn’t really much of a thing in this game: it was getting there. And losing was usually actually funnier. It was through playing this game that we learnt to not take games seriously, as that way you feel no true anger at it, and no need to win, so the desire to play wasn’t nearly so great.

From thence to now, we have enjoyed playing games a lot more, and haven’t craved them nearly quite so much. We are still addicted, but it’s not so bad, and we do it for fun , not because we feel like WE NEED VIDEO GAMES   I find that the games I play, I normally play for a few months obsessively, then get bored of and find a new one. These games normally involve you doing your own thing, and being able to be different to everything else (hello Minecraft, Skyrim, Team Fortress 2 and Don’t Starve).

The Big She (my mother) discourages me from gaming, although allows it for short periods of time. My Dud (sic) is usually working, so gaming isn’t exactly stopped at his house, but he does everything in his power to discourage me. “Isn’t it embarrassing to have spent 200 hours on that game in total?” No. “Don’t you find things like sport and such more fun?” No.
Gaming is something I can do badly and find fun, which is hard to find in other hobbies, and that’s a large part of why I do it.  Most people play video games for fun, and you don’t have to win in order to achieve that. It’s also a good way for me and my brother to do co-operative work against other people (hello again Team Fortress 2) but not have to try hard to succeed, because the whole community shares our whole “We lost….. Yay! that means we did bad! Fun fun fun really who cares lets just play that’s what we’re here for” attitude.

Of course, there are some downfalls (who cares about homework  we can do it tomorrow.) but fortunately I haven’t been as much of a victim to that (lies). But I don’t feel it’s affected me too badly. I have never pulled a sickie though, and as for the whole “Gaming warps your mind balruaghalurah!” thing, my mind feels exceptionally un-warped, so I don’t perceive that as a problem for myself."

It seems to be, from these accounts, that the benefits of gaming are escape, fun or even social interaction for some, and the drawbacks more about time management issues rather than turning into violent, misogynists (although misogyny and video games is another topic that there is plenty of info on out there  and let's face it, is not confined to video games). 

Whether gaming is problematic or not surely depends on the games being played, and whether there is room in one's life to do the other bits and bobs that lead to leading a responsible and fulfilling life.

Frontal Lobe Development

Apparently, the frontal lobe is not completely developed until up to the mid-twenties. The frontal lobe is the part of the brain responsible for long term strategy. It allows us to recognize future consequences of current actions, to choose between good and bad actions, to override and suppress unacceptable social responses".

So perhaps this explains why Brian changed his gaming behaviour, or at least noticed his gaming behaviour when he was 25. There is an interesting post here from Psychology Today on the development of the teenage brain which I think helps explain some of the issues with teenagers, frontals lobes and addiction (in the sense of addiction being a struggle to control behaviour, rather than a clinical addiction). 

I believe that any behaviour where somebody is attached to behaving in a way that impairs their relationships or long term goals, and struggles to stop, even thought they know it is having a negative impact, is an addiction. 

My view 

As a parent, I lay down boundaries on the amount of time spent on gaming. I do believe that it is a parent's job to ensure their child achieves balanced and healthy proportions of everything such as food, caffeine, exercise, school work and video games. Banning the "bad stuff" won't give them any insight into self-control. Explaining why there are curfews will educate them and help them to make informed choices when they are adults. 

If you are an avid gamer, to the point that others in your life may be criticising you for it, ask yourself, are you addicted? What are you trying to escape from? Could you do without it for a couple of weeks?

Amanda Williamson is a BACP Registered Counsellor working in central Exeter, Devon. She has worked with all manner of addictive behaviours, such as addiction to alcohol, drugs, pornography, sex as well as more hidden addictions such as feeling shame, guilt, or caring what other people think too much.

Welcome to Counselling in Exeter

24 September 2013

A Frank Perspective on Panic Attacks

by Amanda Williamson - Counselling in Exeter

I would like to share some thoughts on panic attacks, including some of my experiences as a sufferer which may be helpful for you. Althought it is aimed at sufferers it may also help those that know a sufferer. I did lots of research over the years, to try and get a better understanding of what was happening to my body. I see many people with panic and or anxiety issues, so I thought that I would share what I have discovered.

Have you ever suffered with a panic attack? Do you know what it's like?

If you have never had a panic attack you may find it hard to understand just how horrific and debilitating they can be. I asked what people's experience of having a panic attack was like and got the following responses:

"Like your heart's going to explode out of your chest."

"Bloody awful you feel like your gonna die, legs go weak and you feel as though everything is going grey and no sound... very frightening"

"Your heartbeat becomes audible  - thumping in your ears and chest and throat."

"First your thoughts are like marbles rolling around in your head. They bump into each other and you can not think straight. Then the breathing becomes voluntary instead of involuntary. You think you are having a heart attack"

"It is like being really afraid of something, but you don't know what it is. Your heart is racing, and that coupled with not knowing the cause makes it worse. As it seems to have come from nowhere."

"I thought I was having heart problems and went to the doctor. In the waiting room, a howl crept up from somewhere deep inside and released. It didn't feel like it was me. I then went into hyperventilation and the nurse threw a bag over my face...! I'll never forget it because it was all beyond my control..."

"After losing my Mum and sister within a year I suffered massive panic attacks. Mine were not of the chest pain variety but of an inability to breath without trying really hard to concentrate. The breath would be shallow and very fast where I didn't feel I could take enough air in eventually it would pass but could go on for several minutes and several times in any day."

"I had my first adult panic attack whilst 30ft under water training to get my padi open water diving cert in Thailand. It was horrific and felt I was going to die. I had no control over my breathing or body , I said adult life because after suffering this it clicked that when I was a little girl at bed time I would get panic attacks but I didn't know what they were until I had that same feeling in my adulthood. They now manifest themselves when I least expect them. I can't swallow so start to panic then my breathing goes and the fear of this happening in front of people makes the feeling like a wave even worse. I have experienced violent shakes & cold sweats flu like feeling... it's all incredibly emotional , you feel you have no control." 

I used to think that I knew what a panic attack must be like. I had friends and acquaintances that suffered with them and thought to myself "That sounds a bit horrible" as well as secretly asking myself "Can't they just use rational thought to calm themselves down?". Well pride comes before a fall and I did end up going through a phase of suffering with panic attacks about 8 or 9 years ago.

The Ride of Doom

The first one happened in one of those "fun" simulator rides which consists of a moving, enclosed box in which you sit in the dark, facing a big screen with some sort of motion based movie of a racing car or rocket ride. The ride started and I immediately felt very sick and wanted to get off straightaway, except there was no way of doing so. The nausea was accompanied by a feeling of intense panic. I groped around in the dark for some kind of emergency stop button but there was nothing. The ride was full of people and I didn't want to let it be known that I was petrified so I panicked in silence. The feelings were incredible, like nothing I'd felt before. I felt like I was going to die of fright. It's hard to explain just how convincing that feeling is, but at the time, the only thing that could explain the intensity of feelings was that I was, in fact, about to die.

I didn't die, and when the ride eventually stopped I disembarked, looking around at the cheerful and excited expressions of my fellow riders. I was obviously alone in my terror. I vowed never to go inside one of those rides again.

The Tent of Doom

Then I had an attack in a tent in the middle of the night, in the middle of a field on Dartmoor, in the pitch black darkness. I couldn't find my torch so the panic rose and it was as intense as the time before. I started to take solar lights camping with me from that point onwards.

The Flight of Doom

After a very early morning (aka middle of the night) start I joined the mightiest check-in queue and nearly missed my flight. Once on board, panic started and by the time we took off, I was having a full blown panic attack, racing to the loo, eyeing up the other passengers to see who might have a Valium (having NEVER touched a tranquilliser before in my life). I considered jumping off the plane. This is after years of flying with no issues whatsoever. The flight was miserable and my holiday was blighted with the knowledge that there was no way I ever wanted to set foot on a plane again. I ended up finding a local doctor who prescribed "Trankimazin" (alprazolam - a benzodiazepine). So I did make it home.

The Caves of Doom

During the above trip, following the flight of doom, I went to visit an extensive network of underground caves. I'd always loved visiting caves and never felt claustrophobic or the slightest bit nervous. However, after the flight, I was in a heightened state of anxiety and wondered whether this would affect my willingness to be stuck underground. After quite a long queue I finally shuffled with the crowd down into the caves. The moment I was in I felt rising panic, felt like being sick, turned white as a sheet (apparently) and very quickly, almost automatically, bolted out as quickly as I could, passing the guards who, through their utterances, made it be known that the Spanish word for claustrophobia is pretty much the same as ours.

I sat in the car for a couple of hours, texting friends, nipping to the loo frequently, and trying to come down from the horrific onslaught of chemicals that my own body was flooding me with.

The Mobile Phone Shop of Doom

Things were really bad by this time - I ended up having to switch mobile phone provider because the Orange shop was too narrow and dingy (and orange). The service desks were at the back of a particularly long and narrow mini-shop. I switched to Vodafone who's shop was wide and light and I could breathe properly in there. I realised that this was nuts.

So why am I telling you all this?

Well, after suffering numerous panic attacks in various situations my lifestyle was being impeded and I felt terrible about it. I saw my GP who suggested relaxation techniques and counselling. I did see a hypnotherapist/counsellor who helped me to feel calmer, although I did continue to suffer in certain situations.

The Coach Trip of Doom

One particularly awful attack happened on a coach trip to London. I was going down with the flu, and had prebooked an early morning coach. This coach was driven by a woman who had to stop the coach once an hour to have a cigarette. To make up time, she was speeding in between breaks, and the coach was hurtling down the road, with her accelerating and braking like, well, like a really bad driver. I felt travel sick and very panicky. Because the ride was so long (over 4 hours) my panic attack just went on and on. I felt like I was in hell. Eventually, I lost all sensation in my right arm and my hands went numb. I was in a right state.

These incidents are just a few of many instances which I would describe as constituting a full-blown panic attack.  Eventually I started to notice a few things about my attacks:

  •  They often happened when I hadn't slept enough and/or eaten properly (certainly true for the ride of doom,  flight of doom and coach trip of doom
  • The consumption of a strong coffee often preceded daytime attacks (applies to ride, flight, caves, mobile phone shop and coach trip of doom)
  • The situations pretty much all involved some kind of change in the air I was breathing (more about this below as there is a theory about an increase in the level of CO2 triggering panic attacks)
  • They were worse, and more frequent, in the Winter (ride, flight, caves, mobile phone shop)

Here are some things I've learnt, and which I have applied and which have improved my quality of life considerably:

Why can't we talk ourselves out of panic attacks?

Our survival system is being triggered. The centre of this system is our brain stem which is the oldest part of our brain, often referred to as the reptilian brain because it's all about instincts. Emotions aren't even allowed a look in here (at least not in the immediate moment), and certainly, rational thought has a way to catch up. When it comes to survival we need instant responses, so our efficient systems, when sensing danger, fling us straight into flight-or-flight mode. You can read more about "fight or flight" here. We can apply rational thought afterwards, but by then, with the onslaught of panic feelings, it might be hard to access reason, when our bodies has just been telling us we're about to die. The centre of rational thought is our frontal lobe, the more recently evolved part of our brain. It takes longer to apply rational thought than to instinctively rip our hand away from an open flame. It's quite a good design really. We'd die a lot sooner without it. But if it's triggered unnecessarily, then it's no fun.

Don't be hard on yourself. You aren't weak or feeble. For some reason, you are having an involuntary physiological response to a hard-wired survival system.

Caffeine can make hypersensitive individuals more anxious

I suspected that caffeine was really not helping me at all. Then I read a paragraph on caffeine in the textbook "Abnormal Psychology" where they starkly lay out the facts about caffeine and it's effect on the sympathetic nervous system. As we all know, caffeine is a stimulant and it affects us by increasing our heartrate and brain activity. Our bodies respond by releasing adrenalin, which is the "flight or flight" hormone, which may be enough of a trigger for people who are prone to suffering with panic attacks. I knew that I was very sensitive to caffeine, and too much would make me feel jittery, but I was also very addicted. If I didn't get 2 good strong coffees a day then I would suffer terrible withdrawal headaches. I had a sneaking suspicion that giving up might help me. Most people can consume caffeine without any problems but for hypersensitive individuals, the physiological changes that caffeine induces may contribute to or trigger a panic attack.

It took 3 weeks of making gradually weaker coffee. The headaches were manageable but I did notice that I seemed to need a lot more sleep at first. This did pass and even now, over 4 years later, I do not miss the groggy, caffeine withdrawal feeling of early morning. I also have hardly any panic attacks. In fact, it's close to zero, but I did have one this year, which I go into below.

 There is a well written article here on the effects of caffeine on our bodies.

Could your panic attacks be caused by or contributed to by caffeine consumption?

Blood sugar highs and lows can impact on susceptibility to having panic attacks

When blood sugar levels are low the body responds by releasing adrenaline, which as we've already established, is the fight or flight hormone.  Many people inflict roller coaster blood sugar levels on themselves, by skipping meals or making poor dietary choice when it comes to the energy our food provides us with. Some of my panic attacks have happened on an empty stomach.

Having a strong coffee on an empty stomach is a particularly good way to induce anxiety in me.

Alcohol and anxiety

I can't really mention blood sugar levels without mentioning alcohol, which sends our blood sugar levels plummeting, especially the morning after. I know of many people who have said that with a hangover comes heightened anxiety. The NHS mention it here in their advice on dealing with anxiety.

Have a think about your diet - it can be very helpful to keep a food and drink diary to see if there are any links between what you are (or aren't) eating and drinking, and the occurence of anxiety or panic attacks.

Carbon dioxide sensitivity

I had wondered whether it was the change of air that sometimes triggered an attack. I did some research at the time but, at the time, there really wasnt that much available on the internet making the link between CO2 levels and panic attacks. There's a lot more out there now, although there are no hard and fast answers. The theory goes, that certain individuals have an increaesed sensitivity to increased CO2 levels in the air. So, looking at my doom list, we can see that to a certain extent, my experiences could involve that:

...even the titchy Orange Shop might have had elevated levels of CO2.

This explains why people feel claustrophobia in elevators AND large, packed shopping centres.

There's an interesting blogpost here on the link between CO2 and panic.


So this seems obvious I suppose, but having stressful occurrences can lead to panic attacks, because the stress has caused the body to go into a state of hyperarousal. This can be a result of Post Traumatic Stress Disorder, or a huge stressful event in your life such as the death of a close family member, divorce, work problems, relationship problems...you get the idea.

Some people end up with depression, others end up with anxiety and/or panic disorder. Unfortunately for some individuals they may have both.

Stress has definitely been a contributing factor in my experience of panic attacks. It can be hard to avoid all  stressors; sometimes we are going to have really difficult challenges in life and we need to be able to look after ourselves to navigate those times. You've heard it all before but my GP was right - relaxation tapes, meditation, counselling...these all can help to reduce the physiological responses to stress. I also recommend exercise and mindfulness. Mindfulness is a really good way of learning to listen to your body and stop the racing thoughts that may be plaguing you. You can attend mindfulness classes, or read books, listen to tapes, watch videos on YouTube.

Can panic attacks be "cured"?

I believe that certain lifestyles adjustments can be made to reduce the frequency and intensity of panic attacks. Or at least, these things worked for me:

  • Giving up caffeine
  • Eating sensibly and not skipping meals
  • Making sure I get fresh air where possible 
  • Counselling - this really helped me, so much so that I trained as a counsellor 
  • Sorting out my SAD (see my SAD article here)
  • Reading about it and understanding the phenomenon (here's a good book)

I did have a panic attack fairly recently, in an underground metro whilst abroad. This was the first one in a very long time. There were, I think, various contributing factors:

  • I had been going through a very stressful situation
  • I had received a highly stressful phonecall the night before and had had a sleepless night
  • The air in the metro was incredibly stuffy and, here is an article stating that CO2 levels are actually 20-50% higher on underground metros)

This was the first in a long time. It hasn't worried me. I have a good understanding of what was behind it. It wasn't very pleasant, but it wasn't anywhere near as bad as when I had no idea what was happening to me.

Maybe there are steps you can take to reduce the frequency of your episodes and/or the impact of them.   I sincerely wish you all the best in dealing with your panic.

Amanda Williamson is a professional counsellor working in central Exeter, Devon.

5 August 2013

Do Counsellors Need Counselling?

I am a counsellor. For the majority of my working day I am counselling people.

I also have a counsellor.

This fact sometimes surprises people. I don't make a habit of disclosing this to my clients, as quite clearly, they are paying for me to pay attention to their issues, not mine. But I am not defensive or scared about self-disclosure, and if asked, by a client or otherwise, I have no problem in sharing that I do see a counsellor from time to time.

Sometimes I am asked why. I thought I would share my reasons...for clients, fellow counsellors and the interested layperson to know, should they want to:

Therapy as a trainee

As part of my Advanced Diploma in Integrative Counselling, there was a requirement to engage in a minimum of 40 hours of personal therapy whilst in training. This is typical for many counselling courses but is not a requirement of the BACP. It is an opportunity to engage at a deep level with the lifestyle changes and issues that becoming a counsellor involves. I witnessed huge personal growth in many of my peers whilst we trained together. Part of the training involved practising on each other, with real issues. However, these mini sessions were only 20-30 minutes long, and anything that did come up in that time, could be safely taken to our personal therapist should the issues be requiring of more attention. It was a good experience in learning the value of what we do in our profession.

Putting my money where my mouth is

My hope, in being a therapist, is that people will be able to explore facets of the self that are impacting on their lives in a way which isn't helpful or wanted. This involves deep exploration of the psyche. This can be painful and/or excruciating work. How can I expect my clients to do this if I am not prepared to do likewise?

Keeping "my stuff" out of the therapy room

As a bog standard human being, I do encounter difficulties in my personal life just like everybody else. There may be illness, grief, stress and all manner of human experiences that I am exposed to. To be present with a client I have learnt to put those things "on the back burner" whilst counselling. Having done well over 1000 hours of counselling I am well practised in doing so. Some of these times are more stressful or challenging than others. During those times I will probably see a therapist weekly, so that I can discharge the emotions that the life events may be bringing up, which makes it much easier to put those things on the back burner. If I were to continue counselling other people, and not have an outlet for "my stuff" I would worry that not making the space for it outside, may affect my fitness to practice. Fitness to practice is something that the BACP Ethical Framework takes very seriously, and with good reason.

Continued Personal Development

I want to be a truly open minded person but, as a human being, I am blighted on occasion by prejudgements and misconceived assumptions. I see personal therapy as a way of continuing my personal development, to round off the continuing professional development I engage in.

Do you have any thoughts about counsellors having therapy?

Amanda Williamson is a registered MBACP counsellor working in central Exeter, Devon. 

22 June 2013

Regulation of Counselling and Psychotherapy - What the Public Want



5TH MAY 2016: PLEASE READ THIS POST REGARDING THE PAPER DEMONSTRATING THE NEED FOR REGULATION: http://www.amandawilliamsoncounselling.co.uk/2016/05/regulation-of-counselling-and.html

As many followers of my Facebook/Twitter/blog are aware, the issue of the regulation of counselling and psychotherapy is close to my heart. I have always seen the sense in being part of a body such as the BACP (the British Association for Counselling and Psychotherapy) in order to support my practice and for the opportunity of support for my clients. During my training I attended a BACP Accredited Course at the Iron Mill Institute in Exeter which is known for being a highly professional and ethical training establishment. The advantages of the safety net of regulation was clearly explained to us and underpinned our learning.
As far as I’m concerned, regulation seems to be an obvious requirement for those working with clients who are going through emotionally difficult and more often than not, painful processes. Unfortunately, as in every profession, there are a few rotten apples. Equally, there are some that make genuine errors of judgment (therapists are human beings after all) and an external perspective is required sometimes, first and foremost for the protection of clients,  but also for the professional development of therapists and for the protection of the profession as a whole.

However, the counselling and psychotherapy professions are not currently regulated by law. Currently there only exists voluntary regulation; counsellors and psychotherapists can elect to be a member of  a professional organisation such as the BACP or the UKCP.  
Recently there has been a new register launched by the BACP which is accredited under a new scheme set up by the Department of Health, and administered by the Professional Standards Authority. A peer, Rinske Goettsch has written a post on this register here. Hopefully, if publicised enough, this will assist in the decision making process for those looking for a private counsellor. It does not, however, afford the same protection as that of statutory (compulsory) regulation. As the Professional Standards Authority website states:

"The main purpose of the scheme is to enhance public protection and raise professional standards. The Authority sets high standards for organisations holding voluntary registers and accredited registers require their registrants to meet high standards of personal behaviour, technical competence and where applicable, business practice. This requirement will enhance public protection but it does not have the power to bar people from working in the same way that statutory regulation can."

There are a number of therapists who strongly oppose regulation. Some of them are worried that regulation will impede creativity within therapy. I struggle to see this viewpoint. I suppose the problem here is the definition of the word regulation, or the interpretation of the word, and also what shape the actual regulation takes. As a therapist who chooses voluntary regulation with the BACP, my experience of regulation within that context is that I can practice in my own unique way, with some parameters and expectations (correlating nicely with my favourite Sartre quote: "Freedom is what you do with what you've been given"). I commit to continuing professional development (minimum requirement is 30 hours a year - always exceeded), regular supervision (I exceed the minimum requirement, sometimes double it up when going through difficult times) and choose to be accountable for unethical practice. How hard can this be? I also commit to adhering to the BACP Ethical Framework for Good Practice in Counselling - a very well written document that allows the freedom of creativity within the work, whilst holding some clear boundaries about what is and what isn't okay to do as a therapist. 

Why do I care so much?

Now, I am all fired up and passionate about this issue because I have fallen victim to what I consider to be unethical practice by a therapist. He isn't a member of a regulatory organisation and unfortunately, there are several other women of whom I am aware who are also claiming that he has conducted himself inappropriately. I can imagine why this man is anti-regulation.  I am also aware that I may have a skewed perspective on what I think is right for everyone. Having been stung by my negative experience, and simply from being self-aware, I know how easy it is to see the world through one's own eyes. It is much more difficult to see the bigger picture, when you have you're own little realm of experience that impacts deeply on your perspective.

I need to know more!

So I have been mulling over doing some research, much like that I did last year on client's autonomy in deciding the frequency of sessions. Earlier this month I attended a marvellous workshop on Relational Depth, held by Mick Cooper at Exeter Cathedral. Mick Cooper co-wrote a book that was very influential on my second year of training, when I was honing my approach (Working at Relational Depth, by Mick Cooper and Dave Mearns). I have blogged about the workshop separately as it deserves it's own post. During the workshop, Mick told us to approach him at break times if we wanted to ask him about anything. I was wondering whether to do a poll at the Exeter Respect Festival the following day, and I was musing as to whether it would be useful to do one to find out the public's stance on regulation. Part of Mick's talk was about how we, as therapists, could look at extrapolating our therapeutic approach to our relationship with the profession, not just our relationship with our clients. A truly person-centred way of viewing the profession would be to ask people what they want, and what they think will be helpful, rather than assuming what works. This is an humanistic honouring of our uniqueness (clients and therapists!). This is about the philosophy of pluralism and in fact, Mick wrote a book with John McLeod on Pluralistic Counselling and Psychotherapy.

So during the lunch break I approached Mick and asked if I could get his thoughts on the regulation of the industry. He generously invited me to sit outside whilst he ate and we discussed what I had in mind. I told him that it was a topic close to my heart due to a challenging situation regarding my ex-therapist, but that I wanted to get a broader view of the topic. Mick made a very important point, which seems so obvious now that I've heard it. He pointed out that there are groups of therapists arguing about this topic but that what really should matter is what the public, the clients, actually want. Mick said that he "sat on the Psychotherapy and Counselling Professional Liaison Group, which was drawing up a proposal for regulation of the field by the HPC – which was never accepted by the government in the end. There was a lot of criticism of the group by people opposed to statutory regulation".

This takes me back to August 2012, when I was in contact with somebody closely associated with the Derek Gale case. He told me that it took four years to bring the rogue therapist to any kind of justice. More can be read about the case here. He was struck off the UKCP and HCP (now HCPC) registers (although the UKCP took 3 years to do so), but this does not prevent him from being able to continue as a psychotherapist if he so chooses. The person I spoke to pushed for statutory regulation at the time but became jaded after receiving hostility and intimidation from those fiercely against regulation. This hostility amongst the therapeutic community saddens me. The charity MIND wrote a short piece on Gale and the problems of regulation here. Nothing much has changed in almost 4 years, and the new voluntary BACP register doesn't mean much if the UK public don't know anything about it.

Howard Martin, one of the complainants in the Derek Gale case orginally campaigned for statutory regulation but was jaded by the process:

"I was the original complainant in the Gale case, however while I support a charity that works with survivors of abusive therapeutic relationships and other toxic groups I no longer overtly campaign for the legislation of psychotherapy. I found that the depth of corrupt practise within all disciplines so ingrained and at such a high level that for outsiders like myself it was just too time consuming and emotionally draining. "

The charity Howard refers to is Catalyst Counselling, run by Graham Baldwin who specialises in helping people disengage from abusive relationships such as cults or abusive therapists.

The research

The decision was made; this year's Respect Festival poll would be to discover what the public think about statutory regulation. Do they feel the same as me? Do they care either way? I came up with the following way of posing the question to the public:

Should Counselling and Psychotherapy be regulated professions?

Therapists have been in debate regarding this issue for many years. Some are
staunchly for regulation, some are staunchly against.

I would like to ask THE PUBLIC their opinion, to help inform therapists.

Q: How important is the statutory (compulsory) regulation of counsellors and psychotherapists to you?

                            1 I am strongly against statutory regulation
                            2 I am slightly against statutory regulation
                            3 I don’t care either way
                            4 I am slightly for statutory regulation
                            5 I am strongly for statutory regulation

Finally, are you aware that Counselling and Psychotherapy are currently unregulated professions in theUK?

I was accompanied for the day by Tina Welch, a colleague with whom I work closely, and who's work I value greatly. I believe that Tina works very ethically. Tina is very much with me on wanting to raise awareness and in seeing what it is the public actually want. 

We asked a total of 117 adults to rate the importance of statutory regulation according to the above scale. 40 were male, 77 were female. 5 people were therapists and 2 described themselves as having a background in mental health.

The findings

The answer to our first question gives what I believe to be a very clear message about what the public want. 

In answer to the question asking whether they were aware that counselling and psychotherapy are currently unregulated professions in the UK, 75 people were not aware of this fact and 41 said they were aware. 1 person was unsure whether they knew or not. 

Of those that didn't know, many expressed surprise at this fact and assumed that they are regulated professions (I would like to collect data on that specific issue next time - how many people assumed the professions are regulated and/or are surprised to discover they are not?)

A number of people said that there should be more polling of public opinion on this matter. 2 of the people that expressed this were personally strongly against statutory regulation, but welcomed this research being done.

So not only do the majority of people we asked want regulation, but many assumed it was already in place.

Seal of approval

I passed on the details thus far to professor Mick Cooper and was delighted to receive very positive feedback about this piece. He added the following for me to include in this post:

"The views of the public and of service users are incredibly important when considering issues like regulation and accreditation. So its great to see people asking the public what they think. Really rigorous research here will be critical in helping us ensure that our systems are best suited to our clients' want and needs."

Opinions from other stakeholders

I decided to ask a number of people, whose opinions I respect, their stance in response to my findings and the issue of regulation as a whole. These include a number of therapists with varying opinions, two companies that deal with the fallout of therapist abuse (Catalyst Counselling and The Clinic for Boundaries Studies) and a service user.

Duncan Stafford is a registered and an accredited member of the BACP. He runs a thriving private practice in Cambridge, UK as an integrative therapist and supervisor. Duncan comments on one of the potential problems of having statutory regulation. He says:

"BACP has now taken a different angle to regulation. I wonder if the seemingly good sign-up response to the new register is due to the fact that: 1) it is voluntary; and 2) it appears to be based around the ethics of good practice and protection of the public rather than when there was a drive to regulate therapists through the protected title route. I was resistant to the previous attempt, through HPC, since I felt it was about creating or developing a hierarchy that served no one well and because it seemed to weld a wide-ranging profession to becoming just about a process of ‘mental health’. What about curiosity of self and the whole individuation task? 

However, I wonder what compulsory regulation would really achieve in our field. How much of the process of regulation is a process of ‘threat’. How well do we work under threat? We might think of it as a good response if professionals take ‘fewer risks’. This would be a positive outcome from regulation – but think again. Think about the number of times during a year you are creative as a therapist, how many times you walk with people to the edge of their shadow material and how often you take risks along that route, together in the name of therapy, the moment at which people begin a recovery process. I’d hate for that to be ‘regulated’ out of our profession just because there are a few bad therapists. I would rather that we insisted on a far greater degree of supervision per month. I would rather that we insist that all therapists are members of a professional development group and that we all write a paper each year about what we have learned about therapeutic encounters.

Let’s not make regulation about ‘rule following’ and ‘threat avoidance’. Let regulation be a process of taking the genuine responsibility for our professional actions and development of professional self."

Jane Barclay is registered with AHPP, BACP and UKCP. She works privately in Exeter as a therapeutic counsellor, psychotherapist and supervisor. She has expertise in boarding school experience and runs workshops on this topic. She is also author of the book "Does Therapy Work":

"I’ll be honest – in my early years as therapist I was relieved there was no statutory requirement for regulation, based on my as-yet unresolved lack of confidence or more extreme, being ‘found out’ to be a fraud. During my own therapy, I’ve come to know this part of me a great deal better, which has little to do with my competence with clients and a great deal to do with impact of former abuse and subsequent ‘splitting’ – where one part simply didn’t recognise another, hence the sense of feeling fraudulent.

My overriding view now is that until counselling and psychotherapy are aptly regulated, they will always stay on the periphery, attract mistrust, prejudice and lack of credibility – at a high cost to the general public who might otherwise benefit.

So, please add me to the list of ‘advocate regulation to promote safe and accountable practice.’"

Sarah Ashworth is an accredited and registered member of the BACP and a teacher of counselling skills. This is what she had to say:

"I am in full agreement that regulation of counselling and psychotherapy are essential, at the very least to bring counselling and psychotherapy into line with other professions. Regulation ensures that no one can describe themselves as a doctor of medicine, clinical psychologist, nurse, social worker, teacher or even a chiropodist unless they have been appropriately trained and are registered with the relevant regulatory body. 

Currently, ANYONE can advertise themselves as a psychotherapist or counsellor. There is no requirement for a minimum training and little recourse for complaint if something goes wrong. I am aware of individuals who are advertising themselves as psychotherapists having attended unaccredited courses of only TWO WEEKS duration. Many clients (wrongly) assume that an individual would need to be appropriately trained and registered in order to appoint to describe themselves as counsellors or psychotherapists. I'd like to think that clients would only pick their therapists from either BACP or UKCP's registers, but I'm also aware that this is not always the case. 

As you point out, even in regulated professions such as medicine, nursing, teaching and so on, there are some rotten apples who slip through the net and harm or exploit those in their care through their actions. We are never going to stop exploitative individuals being attracted to professions where they can gain power over others who may be vulnerable. However, as these professions are regulated, these individuals CAN be held accountable for their actions and stopped from practising, if appropriate. Not so with counselling and psychotherapy - at least not at the moment.

I have heard some counsellors/psychotherapists claim that they choose not to be members of either BACP or UKCP because there is little protection if a client makes a complaint against them. From what I understand of BACP's complaints procedure, although arduous and unpleasant from the perspective of the counsellor/psychotherapist, it is nevertheless a fair process conducted by highly respected individuals with expertise of the law, an understanding of those who practice counselling and psychotherapy and of the needs of clients, who may be presenting for support because they have been exploited by others. Please, let's do all we can to ensure that clients are not exploited further by their counsellors/psychotherapists!

In the course of my work, I have heard of a number of therapist comments from "I'm sorry, I haven't been able to concentrate on what you've been saying over the past 45 minutes because I'm hungry; would you mind if I went to the kitchen to get something to eat?" to "so, you haven't had a boyfriend for 3 years...do you masturbate? I do, because my wife won't have sex with me: she's got post-natal depression". When I was in training, I did encounter first hand what it was like to be was the receiving end of such comments (the latter quote was directed at me, by the counsellor I was paying). Fortunately, I realised that my counsellor was inappropriate and terminated the counselling in addition to passing on my concerns. Had I met with this particular counsellor a few years previously, when I was far more vulnerable and without the knowledge of the Ethical Framework and therefore an understanding of the standards expected, I might have been very damaged by the experience and blamed myself for what happened. Although my own experience was unpleasant and certainly not therapeutic, I do think it could have been worse and at least the counsellor was a member of BACP, so the option of a complaint and accountability was available to me. What of those clients who might be financially or sexually exploited, or subjected to substandard, careless and unprofessional practice, by a so-called counsellor who is not a member of any regulatory body?

Finally, let's forget for a moment about whether counsellors and psychotherapists think they should be regulated or not (and quite frankly, I am fed up with this debate - for me, it's a no-brainer...); it's clear from your survey of the public/potential clients, that not only do the overwhelming majority think that counselling and psychotherapy SHOULD be regulated professions, there is also an assumption in the public's consciousness that they MUST ALREADY BE REGULATED! 

As it stands, you or I may be more protected in law if we purchase a cheeseburger which gives us a stomach upset than if we purchase counselling or psychotherapy from an individual who behaves in a manner which is unethical and potentially psychologically damaging. 

Dr Dawn Devereux is a psychotherapist and Director of Public Support at the Clinic for Boundaries Studies, a registered charity working exclusively on abuse by health and care workers. I asked Dawn what she thought about the results of the research, and her thoughts on regulation in general, as I think that she is particularly well place to comment either way:

"The findings of this research are very much in line with the views expressed by members of the public who call the Clinic for Boundaries Studies following an abusive experience of therapy.  If 'therapists' are not registered with a professional body there is nothing that can be done to hold them accountable.  Not surprisingly members of the public can't understand why it is that occupational therapists (for example) are regulated by statute whilst psychotherapists and counsellors are not.  The problem with the lack of statutory regulation is not however just one of bogus professionals with no training.  There is also a problem with fully trained therapists choosing not to register with a professional organisation.  This means that although someone can legitimately claim to be a fully trained and experienced therapist, if they are not registered with a professional body they cannot be held accountable.  When professionals are regulated by statute they are obliged to belong to a regulating body.  I would add that I have noticed that both bogus practitioners and those who choose not to register with a regulator often have very impressive, websites and a string of meaningless accreditations. "

I have aleady referred to Graham Baldwin above. He runs Catalyst Counselling, a charity which offers help, assistance or counselling to those that have been damaged by religious groups or abusive relationships.

"We strongly support the need for statutory regulation in respect of counselling, psychotherapy and alternative therapists. We have been pushing for regulation since 1998. Every year we deal with numerous cases of therapist abuse including financial, psychological and sexual...carried out in the name of therapy." 

He also said that he would go so far as to say that a large proportion of therapists should come with a health warning. 

Somebody else who has been campaigning to raise awareness is Phil Dore who goes by the online moniker Zarathustra. He is a trained nurse currently working in Child and Adolescent Mental Health Services. He has written numerous blog posts regarding the lack of statutory regulation and the problems with the existing system of voluntary regulation. Recently he has written a post aimed at educating the public about the BACP and UKCP's roles in making therapists accountable. He has serious doubts about the UKCP's ability to handle complaints. This is an excerpt from his blog post which he has kindly given me permission to reproduce here:

"It’s not that there aren’t good, reputable psychotherapists in the UKCP. There are many. If I was one of those, I’d be feeling rather nervous about being registered with an organisation that’s likely to wind up officially second-rate. If the UKCP can’t get their act together and develop a robust complaints system – and they may well not be able to do so – then the results are likely to be utterly predictable. All the reputable therapists will sign up with the BACP or BPC. Meanwhile the UKCP will be left with the quacks, cultists and charlatans of the therapy world.
So, if you’re looking for a therapist the take-home message is this. The British Association for Counselling and Psychotherapy has been officially designated as an effective regulator. The British Psychoanalytic Council hasn’t yet but is likely to do so. The UK Council for Psychotherapy hasn’t and probably won’t be for some time, if ever. I suggest you take this into account when hiring a psychotherapist."

And finally I have some input from a service user. Laura blogs regularly sometimes refering to her therapeutic encounters (click here to see her blog). This is Laura's reponse to the reserach:

"As someone who has been to see several counsellors and therapists during my lifetime, I find the discussion of regulation fascinating. When I first discovered that regulation was voluntary I was shocked. To think that professionals who are supporting people in some of the most difficult times in their lives, talking through some of the deepest and most painful things, only need to voluntarily join a regulatory body, just seemed impossible. 

I have experienced bad practice had client confidentiality breached, therapists changed without my consultation, records lost and sessions stopped with no warning or explanation. Not all of those occasions happened while working with counsellors who were not members of any of the regulatory bodies, some were but I just didn't know that there was anything I could do about it. Had I known that I had somewhere to go to voice my concerns and complaints about the professionals who were supposed to be committed to helping me, perhaps I would have felt more confident seeking help when I needed it in the years following. 

Over the years I have learnt more and do understand that counsellors might feel that their creativity could be hampered by being regulated. Perhaps, having to stick to working within the 'rules' set out and not being able to do certain things within therapy that might be considered 'on the edge', but that the therapist feels would help the client. 

Just like in medicine, counsellors could be considered 'healers' and should have the best interests of their client at heart, but this isn't always the case. 

I would never consider seeing a counsellor who is not a member of a regulatory body. Without it, I have a sense of distrust over what 'rules' they are working with me on, creativity or not, I would prefer the safety of some sort of process by which to reprimand a therapist who's work causes more harm than good. There is too much at stake." 

In Summary

People have being trying to change things for years and many, if not most therapists are for regulation. There may have been flaws in previous frameworks for regulation that have been suggested, but I believe that we have a duty to the public, to ensure that people entrusted to work with them psychotherapeutically, are held accountable. This is what the public want. 

I'm not afraid to be accountable. I know all too well of nefarious therapists that are. It's time to protect the people that choose to see counsellors, and to protect the profession.


Amanda Williamson is registered and accredited member of the BACP, with a thriving private practice in Exeter, Devon. 

More posts on regulation:

Guest Blogger Patrick Killeen - Accredited Registers vs Protected Titles (July 2015)

If I had the power to regulate counselling (April 2015)

A new name for the PSA's registers for counselling and psychotherapy (February 2015)

Regulation - a client and therapist friendly way forward? (November 2014)

The problems with a voluntary regulatory scheme (Sept 2014)

Spreading the word on AVRs - the Professional Standards Authority responds (Sept 2014)

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