11 October 2012

Does Therapy Work? By Jane Barclay - Book review

Does Therapy Work? by Jane Barclay
A book review, with Q&A with the author

"You're going to be my father, lover, brother, friend."

"I wish all my clients knew that," replied Sam.

Appreciation at last. Special.

"I know I'm going to try and seduce you," I announced a few weeks later.

"Then let's make a deal, that we don't have sex."

We shook hands and smiled at each other.

Then my campaign began.

This excerpt from the book is printed on the blurb on the back and I found it quite different to what's usually on the back of therapy books.  Does Therapy Work? could be the title of a dry and research-laden pile of boring dirge that I would possibly have forced myself to read whilst in training. The snippet on the back however, promises something fleshier and most definitely more tantalising than a tome of empirical research and justifications that the most reductionist of therapies - CBT - is the only one proven to work (...yawn...).

A great brain

I have met Jane Barclay at counsellor network meetings and I like her. She is very professional and intelligent and I like the way her mind works. She did a very interesting talk on sex addiction and it is clear from the way she talks that her mind works on lots of differing levels simultaneously. I wish this could be measured as I think that it is the sign of a great counsellor. There are so many differing levels going on in the therapeutic relationship - the client's stuff, the counsellor's stuff, the effect on each other, background knowledge of the physiology/neurology/biochemistry of the interactions and emoting, psychodynamic models - there are a myriad of ways of looking at what is going on, which is a skill applied deftly by the truly integrative counsellor. (For more information on this see The Seven Level Model outlined by Petruska Clarkson - one of the frameworks that is used by integrative counsellors to give their work coherence.)

Jane is also a huge Irvin Yalom fan so I know she has great taste in books. I liked the look of Does Therapy Work? so was eager to get stuck into it.

I was also slightly (very slightly) worried in case I didn't enjoy the book and she might ask me for feedback...

An engaging read

Well, a few pages into it I was excited to find that I was very much engaged. She hooked me in with Part One which is split into The Component Parts and Struggle and Suffering. Jane writes about the therapist in training and the requirement to engage in personal therapy. She explores the therapeutic relationship from differing perspectives, drawing from neurology and attachment theory to explain how we form habits in our thoughts and behaviours and the difficulties in therapeutic change, and also refers to her personal therapy, although this is written about much more extensively in Part Two - Demonstration. Jane also writes about our cultural influences, from child-rearing manuals to society's version of happiness. A sample paragraph:

"...it is this very need for attachment to and dependence upon others that carries the greatest risk of disappointment, of betrayal, of experiencing primeval terror of abandonment and helplessness. When out of balance and frozen in conflict, the dual needs for trusting connection and self-reliance can potentially generate the very greatest suffering and lead to infinitely more creative ways of trying to escape this state that actually perpetuate it. Negotiating for balance is a way of living that I call Autonomous Independence which begins at birth and continues up to and including our last heartbeat, breath and synaptic impulse."

Indeed I like this phrase "Autonomous Dependence" as a way of describing the successful straddling of the apparently conflicting needs we have to retain our sense of self amidst the urge to merge with others. 

A book about the power of authentic relationship

This theme is revisited in Part Two where Jane describes the therapeutic relationship between her and her therapist, Sam, a remarkable sounding man. What I very much value about this book is Jane's risk-taking in describing her innermost fears and thoughts in the actual process of her therapy. This is very different to talking about the various approaches and techniques associated with counselling This is a narrative about the very unique meeting of two very unique individuals, which is exactly what every counsellor/client relationship actually is. We can research this and measure that but these are just reductionist constructs which take away the soul of what can be the most authentic and beautiful, if somewhat intense and at times uncomfortable, therapeutic relationship.

Jane shares her secrets, her shadow side, her shame,  sexual jealousies, babyishness and excruciating vulnerabilities in this gripping, moving account of authentic therapeutic process. This is not fluffy counselling, this is bold, visceral relationship. 

Any gripes? I was slightly disappointed with how quickly I finished the book, at just over 100 pages long. That said, there isn't any waffle to cut through. It's 101 pages of pure-spun gold.

In reading Does Therapy Work? I learned that Jane is at heart, like me akin to a Romantic Scientist - valuing scientific research but intent on looking at the whole of the human being, the whole of the relationship.

I wanted to ask some questions

I emailed Jane and asked if she would kindly consider answering a few questions regarding the book. She generously obliged and here follows my questions and her answers

Amanda: How would you describe your theoretical orientation?

Jane: Happy to state that I hate this question! Always have, feel boxed in. The closest I can get is to call how I work ‘Integrative Life Work’.

Amanda: What were your motivations for writing this book? 

Jane: Early on in therapy, I felt compelled to write to stay sane. I simply couldn’t hold all that was flooding in my head/body. Turning what I’d written into a book was a long (ten year) process, as I shaped and re-shaped (loathe to finish) and condensed approx 160,000 words down to 100 pages!!

Amanda: Can you tell me anything about what is was like being so frank with your self-disclosure?

Jane: Being so frank was a relief. Came easily. I just burned to tell it how it really was...

Amanda: Was writing the book a kind of therapy in itself?

Jane: So, yes, writing from day one to completing the book was always therapeutic.

Amanda: Have you had any repercussions since publishing?

Jane: The effects of publishing took me by surprise. I missed writing so much but skipped ‘saying goodbye’ and rushed into marketing. Going public, for real, jolted out of hiding the part of me who was terrified of being condemned and I plummeted into a very dark place for approx 6 months. This too, though, came from childhood experiences – none of my terrors were realised.

Amanda: Are you still in touch with "Sam"?

Jane: My after-therapy contact with ‘Sam’ dwindled in quantity, though we did email from time to time. I don’t judge our contact as ‘good’ or ‘bad’; I’m also pretty certain the child in me remained confused and continued some transference of longing-for-unavailable father. My learning from this is to be clearer about boundaries in the aftermath of a therapeutic relationship.
    ‘Sam’ died last year. I was honoured to be amongst the people to be informed and so went to his funeral. And have since been glad I’ve learned in the last few years how to grieve rather than continue the practice of ‘refusing to mind’

Amanda: What are your favourite therapy books?

Jane: Favourite therapy books?! The ones that speak to me ie are written by people to people. Alice Miller, Irvin Yalom (of course), Judith Hermann, John Bradshaw, Lance Dodes (I think that’s his name – writes on addiction) to name a few authors. Stanley Keleman is another, and mustn’t forget Ronnie Laing!

Does Therapy Work? is available via Amazon.

Jane Barclay has a private practice in Exeter: 

Amanda Williamson MBACP
Counselling in Exeter

Welcome to Counselling in Exeter

2 October 2012

Time to stop being SAD - Seasonal Affective Disorder

Updated Jan 2024, originally written and published in October 2012

The nights are drawing in and I am already noticing how much more difficult it is to get up in the morning. I have my weapon against miserable start-ups though, which I'll go into later.

Most of us are aware of the existence of SAD - Seasonal Affective Disorder, although I suspect that more people suffer from it than are actually aware of it. 

The symptoms of SAD, according to SADA - The Seasonal Affective Disorder Association website (click on link to read more):

  • Depression
  • Sleep Problems
  • Lethargy
  • Over Eating
  • Loss of Concentration
  • Social Problems
  • Anxiety
  • Loss of Libido
  • Mood Changes

About 10 years ago I noticed that although I enjoyed the idea of winter, roasts, fires, snuggly clothes, cosy nights in etc,  the reality of the lack of daylight really got to me, on a physical level as well as mood-wise and by Christmas I would feel quite dreadful. I originally thought that maybe I had hang-ups about Christmas, and yes, the frittering of large amounts of cash for a load of c**p does sicken me slightly...but the idea of a mid-winter celebration to cheer up the depths of winter sounds marvellous....in theory. So why did I feel so grumpy?

As the years passed by I noticed that I was desperately craving light in the winter and would avoid darkened rooms - they made me feel agitated. On gloomy, mid-winter days, I felt almost suffocated by the darkness descending around 4pm. I became appreciative of the fact that trees lost their leaves so that a bit more sunlight could reach me.

About 5 years ago this self-diagnosed SAD came to a head. I noticed that every winter I was becoming more and more antisocial, that I was struggling very hard to get out of bed in the mornings - it felt like torture. My appetite was affected and my activity levels slumped. Whilst I think a certain amount of adjusting to the winter season is inevitable, I found myself spending nearly half the year feeling low and increasingly anxious. 

The Magical SAD Lamp

I researched the topic, on the internet and from books from the library. I decided that I should try a SAD lamp and spent hours looking into which would work best for me, or, indeed, work at all.

The Litebook
The reason behind why SAD lamps seem to work, is that in the winter there is a lot less light reaching our retina, and it is the action of sunlight on our retina that signals the body to stop producing the sleep hormone melatonin. By using the lamp we are telling our bodies that it is time to wake up.

I settled on the Litebook as it's small size and portability appealed. It is so powerful that you only need to use it for 15 minutes a day to feel the benefit. The slight downside is that you are advised to use it from September to gain full advantage, and use it until April. I bought mine in November so didn't get to feel the full benefits the first year, although it did help me to feel more awake and I noticed a big reduction in my SAD symptoms. The following winter I was even better, significantly better than I'd been in years and even arranged a birthday party for the first time in a very long time (my birthday is at the end of January, a time when I used to be at my peak of misery).

I use my lamp for 20-30 minutes in the morning before getting up. I read or check emails while lying there with the light shining towards my face. By the time the session is over I feel ready to get out of bed. More ready, anyway.

Sometimes, especially if I have an busy evening planned, I will use the lamp again late afternoon to give me a boost. A secondary use for the Litebook is for jetlag and I can confirm that it can be effective in helping if you suffer with that. I use it in conjunction with melatonin supplements, which you cannot buy in the UK, but American drugstores have loads of the stuff.

Jan 2024: for the last few years I have been using a lamp by a brand called Beurer. This year I bought a new model which is brighter than any I have previously owned and is, I feel, more effective.

Other things to help enjoy winter:

Keeping warm 
I wear warm, woollen clothes and fur-lined boots on cold days, and thermal under layers if needs be. Also, I'm not as stingy with the heating as I was brought up to be.

Eating well
I try and keep to my usual, reasonably healthy diet which includes lots of salads, vegetables and fruit. Once I start going down the quick-burn carbs route I find it hard to get out of the cycle. 

Jan 2024 update; I have been taking a liquid probiotic called Symprove to help with gut flora.

The levels of exercise are not as high as during the summer months but I make sure I do something. Any sunny days I try and get out for long walks meaning I get more precious light hitting my retina.

Jan 2024 update: since 2020 I have been doing year round cold water exposure by sea swimming. It's even better in the winter! I also have 2-3 minute cold showers in the morning. It's even better with music playing loud!

Winter Sun
I have yet to be in a position to be able to do this, but due to current commitments I cannot jet off for a week's sunshine to get a boost. If I could, I definitely would.

Jan 2024 update: I have done this the last two years, but not this year. 

The NHS suggest that counselling or psychotherapy can be useful in alleviating the symptoms of SAD and I can confirm that I personally found some benefit in having counselling several years ago when I thought that there was something wrong with me; when I felt rather ashamed and somehow feeble for having SAD. Suffering with SAD may exacerbate existing issues with relating to others and with one's self-worth.  Counselling can help you with these difficulties. 

Here is a useful link with more information on SAD from the NHS website:


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