3 June 2018

Processing Data Policy – A guide to what I do with your details

Data collection

 I will collect your name, address, email address, telephone number, date of birth and your GP’s details. I will also collect potentially sensitive data such as physical and mental health issues, medication taken, family details and reasons for counselling.

 During sessions I will write down some of the salient points and issues as they arise.

Process and use of this data

 All details are restricted to hand-written paper documents which are stored in a locked filing cabinet.

 The contact details allow me to contact you during our counselling sessions. I will only share this information with the police or your GP if I believe you to be a significant risk to the lives of others or yourself through stated intent to commit suicide. I am also legally obliged to notify the appropriate authorities regarding terrorist activity or drug money laundering.

The notes regarding sensitive personal details assist me in working appropriately with the issues you bring. I may refer to and discuss the content verbally with my clinical supervisor however your identity will be concealed.
I may share information I hold about you, if requested to by my insurance company, in the event of a complaint made against me.

 Disposal of data

 I will hold all data in my filing cabinet for a period of 7 years following the end of therapy. All notes will subsequently be destroyed.

 Letters to third parties

 Where I am requested by a client to write a letter to a third party such as a solicitor, GP or to write an invoice which includes your data, I will delete the files from my computer and keep a hard copy with your client file in my filing cabinet. The laptop I use for writing such letters is for my business use only and is password protected.

 Clinical Executor

 In the unfortunate event I can no longer work with you due to my sudden sickness or death, I have appointed a clinical executor who will have access to this data to notify you of the situation.

 Consent
Please sign below if you consent to your above details being stored in this way:

Name:   ________________________________________
  
Signed: ________________________________________    Date: ______________________________

(Updated 3rd June 2018)


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2 May 2018

Thoughts on weight loss and the role of Counselling and Coaching - with guest Health Coach Adele Stickland

I often see clients who want to explore issues around weight. The work I do with these clients usually includes elements of discussing underlying factors which can be many and varied.
 

Sometimes it makes sense to look at the historical relationship with food. I have struggled with sugar cravings and can link that back to my naughty “sugar missions” as I used to call them. At around age 7 or 8, when the family were all busy doing something like watching telly, I would raid the baking cupboard and help myself to golden syrup, granulated sugar, ice cream toppings…I remember how soothing it felt if I was lonely or bored. It’s no wonder I get a buzz from it as an adult! As well as the physiological response there would be the brain chemical rush and the thrill of being naughty. Alcoholism features strongly in my family tree too and there is understood to be a link between sugar and alcohol addiction. Exploring things like this can help us to be less judgmental towards ourselves and in fact judgmentalism towards ourselves can increase our need for sugar in order to soothe the bad feelings we have created for ourselves. It’s a vicious circle.
Me aged around 8 or 9

Some of us may have had a parent/s with a complex relationship with food that impacted upon us as a child. If a child has a tendency to carry a little excess weight then they may have been inadvertently or overtly shamed by parents, other children or even, I have heard, by compulsory weigh-ins at a "fat clinic" for overweight children in decades gone by (I really hope those died a death). 

Compulsive eating and diet sabotaging have lots in common with other compulsive behaviours such as problem gambling, alcohol addiction, even an attachment to an unhealthy relationship. My therapeutic interventions are informed by the training I did with SMART Recovery, the specialist training with the gambling charity Gamcare and the work of Candace Pert, author of Molecules of Emotion who was the neuropharmacologist who discovered the opiate receptor. Candace Pert makes a compelling argument for how we can be addicted to emotional states, even bad ones, because we crave the chemical signals our bodies get used to receiving.

An example of a practical tool I might use to help understand the underlying dynamics in compulsive behaviour is the SMART Recovery "Motivational Matrix". Here is a made-up example of one for sugar addiction:





There is almost always nothing in the Long Term/Positives box, regardless of type of compulsive behaviour. Doing an exercise like this can help us see clearly in black and white just how much the negatives feature in our vicious circle. Controlling impulses in the short term can be easier if we know what we are really up against.

"We sit down and eat for pleasure, using all of our senses," Mireille Guiliano, author of French Women Don't Get Fat

This sums up a final piece of advice from me. If we have committed to eating that bar of chocolate, which lets face it, if we're on the way to the cupboard to get it then it's going to happen, then can we actually allow ourselves to enjoy it? Instead of self-flagellating ourselves with feel bad chemicals which trump any of the pleasure, let's think about the pleasurable aspect and eat mindfully. So many people I have worked with tell me that they eat compulsively whilst watching the TV and don't even notice what they are doing or feel the enjoyment of it. It's become a compulsion and we are missing out on the point of the "naughty but nice". 

Coaching 

So with all that understanding and insight there can still be the need to strategise in order to implement the changing of ingrained habits. Some of us might benefit from support in implementing changes to our diet and lifestyle without dipping into the past, Depending on your personal situation it might be preferable over counselling and psychotherapy altogether to go straight into working with a coach. 

I have been following the work of my previous Pilates Coach Adele Stickland over the last few years as she is also the online Get Gorgeous Health Coach. I invited her to be a guest on this blog as I would like to share her work and the concept of health coaching. I really like Adele’s style. She is very down to earth and sets realistic goals. She works with women around 40 and over. Adele kindly agreed…


Hi Adele, I came to you initially for Pilates classes (which were wonderful by the way and only stopped due to my schedule) and since then have followed your Get Gorgeous Facebook page and blog posts. What was behind expanding your Pilates business towards online nutrition, health and lifestyle coaching?
Adele Stickland - Get Gorgeous Coach

Hi lovely Amanda

Yes that is right I remember the very first class you attended, you were strong and a little inflexible but with Pilates practise you soon changed that.

I started teaching Pilates over 20 years ago, at first I was using it as a down time from my ‘real exercise’ of high impact aerobics, step, BodyPump you know the normal crazy things we used to do. I soon realised I was addicted to this type of adrenalin exercise but it was not doing my body or my mind any favours.

Currently I only teach Pilates and I am reducing my in person classes steadily.  As I grow I realise for myself I need to reduce my face to face teaching hours and increase my online presence.  It is an industry trend, but also fits my home and my own mental space.

As an instructor I was constantly talking to people about the right things to eat, something that I was confused about for years.  As instructors we were all on the eat more carbs band wagon so we could keep exercising, Over the years I learnt that bread and pasta were giving me a short burst of energy but a huge tummy. 

My online Get Gorgeous business grew because of the pain of listening to women in particular enduring that roller coaster diet ride which is addictive and damaging.  I was staggered by comments from women who were diet leaders for WW and SW and were adding ‘aspartame’ to their food to make it palatable but completely unaware of the health issues.  I realised with shock and frustration that Diet’s simply aren’t a healthy way to live.

I was really taken with the video on your Facebook Page (https://get-gorgeous.com/why-weight-gain-is-not-your-real-problem/) where you tell us that weight gain is not the real problem. I think that this hits home with many of us. I totally agree with you and find as a therapist that all compulsive behaviours (including the compulsion to eat not-so-virtuous foods) seem to be more about the vicious circle of 'drama' (the word you use in the video). This is absolutely what I see. Whether it be eating, drinking, gambling, shopping; along with the hook of the buzz (the dopamine/serotonin/adrenalin etc) is the crash of guilt, shame, self-judgment. The peptides that our body releases when we feel those painful emotions can in theory be as addictive as the pleasure hormones!

Diets focus on the outcome of the fridge scenario, and how to stop you when you get to the fridge. With no planning or understanding of what you are doing you are bound to find a quick fix or a diet snack. Both are low quality food choices and then you then work through that guilt, shame and personal disgust scenario.  It is extremely painful and demoralising. Get Gorgeous works before the fridge scenario takes over.  Firstly look at what you are going to do for the week and plan out your healthy options.

Which, okay that is what every diet recommends, but what is different about Get Gorgeous is we look to stop the ‘mind chatter’ the detrimental chat in your head that causes your stress and begin to break the negative cycle and change the way you ‘chat to yourself’ before you head to the fridge.

Once you get to the cupboard or fridge door IT IS TOO LATE!  You are never going to resist. Yes, you have worked hard, too hard, deal with the working hard issue not the battle at the cupboard door.

Your weight gain is not your main problem, it is not your biggest worry.  Your weight gain is a symptom of a deeper issue.  Weight gain is not the cause of your discomfort or displeasure with your body, it is the result of deep insecurity and deep feelings of resentment that have not been dealt with from your past. 

You may never know why you feel intensely uncomfortable when somebody says something innocent to you.  You may never understand the exact cause of that feeling in your belly or your throat.  But you can understand it is there and learn how to move past it. There are productive and satisfying ways of dealing with your food or any type of anxiety demon.

It takes a little bit of awareness and an appreciation that you are gorgeous.

Please would you tell me something about what you provide? Who might benefit from having a chat with you and why?

I offer a way of adding good nutrition into your busy life with ease and flow, I work with you to find a way to add exercise into your life and I offer a safe space to explore why you react to stress and manage a situation that moves away from old eating habits.

I offer a group programme and one to ones, depending on the work my gorgeous girls need.

I specialise in working with women who are heading to 40/50 or 60.

What top three-lifestyle issues would you say we might all benefit from tweaking, to enhance our health and happiness? (no pressure!)

Great question and interestingly enough I have written a blog on that here is the link:
https://get-gorgeous.com/boost-your-energy-in-as-little-as-21-days/

In essence I would a start by suggesting eating more protein, women in particularly are depleted in this macronutrient and our energy levels are illustrating this lack of nutrient. Once that habit is established and you start to feel better, more energised and motivated then I would slowly help you to increase your exercise, and finally I would slide in a reduction of your sugar or quick fix habits you have relied upon, for instance chocolate bar in the 4pm slump, sweeties on a long journey, coffee and cake at mid morning. I wouldn’t start with the scary stuff, I start small and help you to feel better first.

Let me show YOU can improve your health and create healthy habits and strategies. Become the real you and step into the person you were meant to be. APPLY for some time with me.

Adele x


A massive thanks to Adele. How did she know about my 4pm slump?  I highly recommend her Exeter based Pilates classes and she also sells Pilates DVDs. You can find her Get Gorgeous Facebook page here. 

 I mention how activities such as Pilates can help the therapeutic process in this article: http://www.amandawilliamsoncounselling.co.uk/2013/08/top-5-lifestyle-tips-things-to-do.html



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



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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.



preview 2 comments

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 (now known as Carolyn Spring). 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.

(links updated Jan 2024)



*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.
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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.



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