My Work — Avigail

Individual therapy

I work with adults over 18 on a wide range of life issues, as you can see from the list on the right hand side of the screen. I am interested in what people can become and what they can do to fulfil their potential. At the core my work is humanistic and existential, which means that I treat my clients as human beings and not as objects. I know that there is much more to a person than the problems and difficulties that bring them to therapy.

In my work I draw on a rich and creative tapestry of ideas, approaches, wisdom and techniques. I am Gestalt trained and work experientially with my clients using psychodramatic processes where appropriate. Working experientially means that sessions never run out of energy. They are always relevant and address what clients need in the here-and-now, while keeping an eye on the client’s overall goals for therapy.

My work fits well within the new perspective of Interpersonal Neurobiology (IPNB — More on this soon), which means that we now have a scientific basis for psychotherapy coming from the field of neuroscience. We now understand much better how and why change happens in therapy. This is because we have a much better understanding of how the therapeutic work and environment affect people’s brains. Being grounded in science leads to more robust, more accurate and more effective therapy.

I don’t dictate the pace of therapy, the number of sessions or how often people should see me. I actually do not believe that it is OK for therapists to do that. I ask my clients to keep an eye on the gap between their sessions and notice whether it felt too long, too short or just right. This way clients decide for themselves what works for them. Some people need more time to process between sessions and some people need less. My experience has been that things work best when clients are in charge of their therapy process and that includes not just what we deal with in each session but also the pace of therapy, the gap between sessions and the length of therapy.

There are many reasons why people find it hard to be all they can be, and my job is to help my clients work through these so that they can remove the obstacles that can get in their way. I treat therapy as a joint venture between the therapist and the client — in professional jargon this is called ‘therapeutic alliance’. This means that I see my role more as a facilitator and ‘companion on the journey’ rather than as an ‘expert’ whose job is to ‘fix’ people. Good therapy is an encounter between two human beings, not between a machine and a technician….

As a humanistic therapist I believe that people deep down have the answers to their problems and questions. My job is to help my clients discover their own answers rather than to tell them what to do. I really don’t think it is possible for one human being to ‘fix’ another, but I certainly believe that if we work together, a lot is possible.

I believe that the purpose of therapy is to help people become independent and autonomous and not only to make uncomfortable symptoms go away. Symptoms, as unpleasant and uncomfortable as they might be, can be a blessing in disguise; something in us that alerts us that not all is well and there are things about ourselves and the way we live that we must pay attention to.

Although I expect individuals to take responsibility for their own journey, I do not focus on people in isolation. I never forget that people live within rich life contexts of work and relationships. As individuals we have an impact on our environment, but our environment also has an impact on us. We don’t live in a perfect world and I know that people have to get on with things ‘out there’. So while I believe that individuals have a significant say in what happens to them I never promote the idea that ‘if you only fix yourself up everything will be OK’. Things are usually not that simple. So when people start to look at what goes wrong for them, they often also have to look at their relationships and their home and work environments to make sure that there are no harmful elements there. An example could be living or working with abusive people. Part of good therapy can be making important decisions about one’s direction, purpose and living and work conditions. It usually takes some time for people to get to a point where they can make those decisions. I have seen countless clients reach a level of maturity and strength that allows them to make necessary external changes to their lives so that they can continue to develop.

Another reason I don’t see therapy as a purely individualistic endeavour is that I know that as a human race we are all connected. For example, we all know now that global environmental problems are not confined to any one part of the planet. We are all affected by what is happening to the world’s climate, and in order to deal with these problems successfully we must work together.

I think that every human being who (for whatever reason) misses out on becoming all they can be, is a loss to all of us. I am  passionate about helping individuals make the most of who they are because I want people to be happy and fulfilled, but I also believe that this will benefit the whole of humanity. The more people develop maturity and integrate (More on this soon — Keep an eye for new material I will post on Interpersonal Neurobiology or IPNB) the better the world will be for everyone.

Don’t get the idea that I push my clients to become political or social activists. I don’t ‘push’ my clients to do or be anything. But these are the things I believe and that give my work a sense of meaning and purpose. I work with myself all the time to make sure that I can be the best companion for my clients as they embark on the courageous journey of therapy. I don’t ask my clients to do anything that I am not prepared to do myself. Therapists aren’t required to be perfect or problem-free. That’s not possible as we are all work in progress. But I am committed to my own growth and development and this is a journey that I am committed to for the rest of my life.

One of my teachers, Hugh Crago, once said that ‘therapy is not for the faint hearted’. Therapy can be difficult and painful, especially if we have a lot of healing from past hurts and traumas to go through, and we all have our baggage. But it is also an inspiring journey that leads to a much richer, freer and more fulfilling existence.

Top of page

Relationship therapy

My psychotherapy degree is both in individual therapy and in family and relationship therapy.

In relationship therapy the client is not the individuals but the relationship. I am not invested in keeping people together or separating them. My job is to do what is best for the relationship and for everyone involved. As with individual therapy I seek to develop a therapeutic alliance with the couple, and have a shared and clear understanding of the goals and purpose of therapy.

Couples (or people in other types of relationships, e.g. siblings, a parent and a child, friends, business partners, etc.) come to therapy for many reasons. Relationship therapy can be a great vehicle to creating a satisfying and safe relationship for both people where they can continue to grow  and achieve their goals together, whatever these goals might be.

If there are children involved it is even more important to invest in the parents’ relationship. As a family therapist I know that it is the parents’ personalities and the quality of their relationship that set the tone for the entire family and will in turn affect children’s wellbeing and development. The human brain develops in response to the emotional environment we grow up in. Neuroscience and research on attachment tells us now that our brains are ‘sculpted’ or wired by the emotional atmosphere and the relationships that are around us in our infancy. Children need secure attachment to grow up well, and it’s up to parents to provide it. It is easy to see why it is so important for parents to develop their own maturity and the maturity of their relationship. It’s much more than setting the right example for the children. It’s about how the children’s brains will develop in the environment they’re in. (For more information on this particular point I recommend the book Parenting from the Inside Out by Daniel Siegel. I will discuss this topic more in an upcoming section on Interpersonal Neurobiology.)

Ultimately we believe that to have a satisfying relationship, both partners need to be committed to their own individual growth and work to increase their individual level of maturity as much as possible. Unfortunately, relationships based on emotional dependency, addiction in one or two of the partners, immaturity or avoidance of issues do lead to a great deal of suffering and have a negative effect on children’s development.

There are many things that can affect relationships. It’s actually quite a task to bring two different people together who have a different history, and different personalities and ways of being and doing things. Things can get particularly challenging for couples around big life changes. It’s usually when people are in the process of adjusting to a significant life change, that the strengths and weaknesses in the relationship are revealed. If you are going through, or have gone through important life changes together, have a look at my article on grief and adjustment to change in the Resources section on this site. You might feel a bit more reassured about how the change might have affected you, your partner and your relationship. The article might help you to see your relationship difficulties from the perspective of change and adjustment to change.

Working together as a couple has benefits that don’t exist in purely individual therapy, and couple work can be inspiring and life-changing. It amazes me every time when suddenly in a session two people really meet and see each other as human beings for the first time, sometimes after many years of just living alongside each other. It’s easy to slip into life’s routines and lose touch with one another. For many people closeness and intimacy can be scary or strange, they might not have seen an example of it in their own family of origin. There might be cultural or generational differences that can affect how people relate to each other, how close or honest they allow themselves to be and what they expect in close relationships. Many people don’t realise how little they really know or trust their partner. But everyone knows when their relationship is causing them pain, or is empty or lonely. Relationship therapy provides the safe space that is needed for people to experiment with being together differently, so that they can then take these experiences out of the therapy room and into their real life.

My work with couples includes among other things teaching and practicing communication skills, emotional skills and conflict resolution. These help from the start to establish the good will and safety that may have been eroded over years of dissatisfaction, disappointment or conflict. However, good relationship therapy must not focus only on the content of what people say. If it does, it’s not likely to be effective. The focus of attention in relationship therapy needs to be on process (as opposed to content). This means that the focus isn’t only on what people say, but on how they are with each other. I am trained and practiced in observing people in the here-and-now and in focusing on process. Working this way make it difficult for people to ‘hide’ behind words and this is one of the reasons that relationship therapy is so challenging.

As with individual therapy there are no quick fixes and I can’t ‘do it’ for the partners. Partners, like individuals, have to be committed to their journey together. They have to have a shared goal or goals to work towards, and be prepared to practice new skills and ways of being with each other so that they can move forward.

Please be aware

Couple therapy must not be used for one partner to try to ‘fix’ or change the other. Both partners have to be prepared to change and grow together and as equals.

I do not engage in relationship therapy if one or both partners in the relationship are actively addicted to drugs or alcohol, or have any other serious addiction like gambling for example. As with individual therapy, people have to be completely clean and committed to their recovery to engage in relationship therapy with me. People who have an addiction are psychologically and emotionally unavailable to be in relationships with others. Their main relationship is with the object of their addiction. In theses situations relationship therapy is not only pointless, but can also send the wrong message and potentially be harmful to the non-addicted partner in the relationship. Although addictions are usually a symptom and not the real problem, addictions in relationships cause problems that cannot be dealt with until the addiction is out of the way. A partner who has an addiction must acknowledge their addiction and get help for it before they are fit to engage in relationship work. If you are in a relationship with an addict or if you have been affected by someone’s addiction, you might want to consider joining groups like AlAnon or similar groups or services that can help you deal with and recover from the effects of that addiction on you. (Please be aware that parent’s addictions have a very harmful effect on children and young people. I believe that parents who are addicted are in violation of their duty of care towards their children.)

I do not engage in relationship therapy where one (or both) partners have a personality disorder, or where there is violence or other forms of coercive control.

If you live with a person who has an addiction, or if you are a victim of domestic abuse or coercive control, you must seek help for yourself first, and for any children or vulnerable people who might be affected by the relationship. Relationship therapy is not safe and not appropriate in these situations. Taking people to safety is always a priority.

Top of page

Fully Human Psychotherapy & Counselling is welcoming to the LGBT community

As someone born into a Jewish society, a group with a long history of discrimination, marginalisation, alienation, racism and persecution; as someone born and raised in Israel, one of the most racists societies I know, and as an activist for the human rights of the Palestinian people, I am particularly sensitive to issues of racism, marginalisation, discrimination and persecution of all kinds and against any group. I am concerned about people who for whatever reason choose to hate or discriminate against a particular group, or those who advocate the exclusion (or even killing) of any group in society and do not see this as a problem in themselves. Obviously I am also deeply concerned about those who are the victims of such people.

While I do understand that fear of the ‘other’ or fear of ‘difference’ possibly has mammalian, biological origins, I do believe that humans have the capacity to grow beyond this and develop into accepting and compassionate beings. I also believe we all have a duty to work towards this and to educate our children and help them do the same.

I am very fond of the principle of ‘responsible spontaneity’ that was introduced to me when I studied Gestalt therapy. It means that we should all strive to be ourselves and as alive and as spontaneous as possible provided we do not violate the rights of others. In other words, we can’t just do anything we have the impulse to do, or act on whatever whim, emotion or need we might have in the name of our own right to spontaneity, if it violates the human rights of someone else. (In my world that also includes the rights of non-human animals.)

Even those who have a problem with another group have a right to their opinions or feelings, whether they are based on  religion, upbringing or culture. However, I draw a clear line between belief or feeling, and behaviour. This means that while people are entitled to not like others, they do not have a right to push for or promote rules or laws that result in discrimination against those they don’t like, or to take any action that would discriminate and marginalise others or that persecutes them. I follow and expect others to follow the principle of, ‘Do not do to others what you don’t want done to you’.

As an accredited member of the BACP I am obliged to adhere to the BACP Ethical Framework. The Framework now includes a prohibition on ‘conversion therapies’ and requires therapists to treat LGB&T clients the same way we would treat all clients, as people with inherent human rights and dignity who deserve to be treated with equality and respect (see ‘Update to BACP Statement of ethical practice (1)’ at the bottom of the Ethics section of this website).

I am pleased about this relatively recent addition to the BACP’s  Ethical Framework, but even without it I have always treated all my clients including members of the LGBT community as equal to me and anyone else, and have never discriminated against clients on the basis of gender, race, age, religion, disability, sexual orientation, gender identity, or anything else.

*Please note that I reserve the right, and have the ethical duty to refuse to see client groups whose needs are beyond the scope of my work, or with whom I am not trained to work. (See my leaflet for more details.)

I was taught many years ago that rules or laws don’t need to exist when a problem doesn’t exist. This means that the BACP or society in general would not need rules or laws to protect the rights of LGBT people (or anyone else), unless discrimination still existed and unless appalling things like ‘conversion therapy’ were still being practiced out there. While having such laws and rules is an indication of progress in society, and while I obviously welcome the new addition to the BACP’s Statement of Ethical Practice, I am also aware that this means that the problems are very much still there.

It saddens me that even now in the 21st Century, after everything humanity has already been through, some people still think it appropriate to hate others just because of who they are. I therefore look forward to, and in my own way always work towards, a time when discrimination against LGB&T people or anyone else will be a thing of the past, and when we won’t even have to talk about this as an issue because it won’t exist.

As part of working towards this purpose I regularly examine myself (and ask any therapist I supervise) to always do soul-searching and make sure we don’t harbour any hidden prejudices that we are not conscious of. If we do find something lurking in the shadows, the expectation is that we explore it, treat ourselves with understanding and compassion and work towards developing an accepting and compassionate attitude to all humanity. I believe each person in society should be educated to do the same from a young age, and be encouraged to discuss his or her fears of whomever they perceive as the ‘other’ or the one who is ‘different’, in a safe and supportive environment.

So members of the LGBT community (or any other group that finds itself mistreated or marginalised for whatever reason) are welcome to see me for therapy, safe in the knowledge that I do not discriminate.

As a non-LGBT myself I might not know everything there is to know about the specific needs of members of the LGBT community or some of the particular issues they are dealing with. Having said that, my experience has shown me that although there are contexts and circumstances that are unique to the LGBT community, in many cases the issues brought to therapy are the same as issues brought by non-LGBT clients. Either way, LGBT people need to know that whatever issues they bring to therapy, they will be treated in exactly the same way as issues brought by non-LGBT people. I will never assume that the fact of being LGB or T is the main issue, unless of course the client tells me that it is. (All my clients set their own agenda for therapy and I work to help them meet their goals not mine.)

The relationship therapy part of my degree included an intensive module on working with same-sex relationships, and I have many years experience working with same-sex couples. I am fully aware of the traumatising effect of discrimination, bullying, exclusion and having to hide the essence of you are because of the fear of rejection and persecution, and have extensive experience working with trauma caused by any kind of maltreatment.

Good therapists should be always learning and developing. So I am open to learning from all possible sources as well as from my clients, in my quest to offer the most effective, respectful and safe therapy possible.

 

Top of page