This counselling service is strictly:
• NOT crisis intervention (See important notice for emergencies).
• NOT for individuals who are currently abusing drugs or alcohol. In order to see me, you must already be well into your recovery, be clean and have a comprehensive and well-established support network. An individual psychotherapist in private practice is unable to offer the resources that people need when they are just starting on their recovery journey from serious addictions to substances. I can see people who drink just a little bit here and there, socially, etc. But I advise all of my clients that if they want to achieve anything in therapy they have to be alcohol-free. Which means, I prefer that my clients do not drink at all. To read more about this please have a look at my article on Substance, where I explain in some detail the relationship between alcohol and therapy.
(For anyone who is interested, I am teetotal. It is not a moral issue for me, but a practical one. I am passionate about personal growth, mine and everyone else’s. To grow towards our potential we need a clean brain that is always at its best and is free to form new connections and reinforce them. I therefore do not consume anything that can compromise my brain).
• NOT for individuals with a serious psychiatric diagnosis such as bi-polar disorder, personality disorders, schizophrenia, psychosis, etc. I am simply not trained to work with these or similar conditions. Working ethically means working within my competency and training and not risking doing harm by attempting to use an approach that is inappropriate given the person’s diagnosis.
• NOT a substitute for necessary medical attention or hospital care.
• NOT a ‘repair shop’ for the mind. People are not broken objects like cars that need fixing in a garage. People are developing beings that need support to grow and develop.
• Please be aware that I cannot see members of the same family or people in other close personal relationships at the same time for individual therapy. Working with individuals who are related or in a close relationship when it is not for relationship/family therapy, can compromise the quality of the therapy. As a professional I am able to maintain excellent boundaries, however there is alway an ethical concern that people would, consciously or unconsciously, limit or censor what they say to the therapist if they know the therapist is seeing another member of their family, a close friend, partner/spouse, etc. Once therapy with one person has well and truly ended, it can be possible to see other people from the same family or the other person in the relationship. This will only be done after careful consultation with the people involved and with the intent of safeguarding clients’ confidentiality and wellbeing.
• I do not accept referrals from EAP companies or other referral companies. I only work directly with clients. I can provide direct EAP service to employers. If you are an employer and would like your employees to have access to my services please contact me.
• I do not practise CBT (Cognitive Behaviour Therapy).
I am strongly opposed to CBT as an approach to mental health and therapy, and discuss my reasons below. I am writing about CBT in some detail here, because I am concerned about the fact that the NHS offers it to everyone as a matter of routine, and because a lot of people are misled to believe that it is an ‘evidence-based’ therapy, and therefore a good quality, or effective therapy that is suitable for everyone. (I did study CBT as part of my original psychotherapy degree).
CBT in EAP (Employee Assistance Programmes) & Other Contexts
In Australia (where I trained and where I practised for eleven years), psychologists (practitioners with a psychology qualification) are trained primarily in CBT, and not much else. Here in the UK, there is an idea that you can train nurses, or other people who are not qualified mental health professionals to ‘administer’ CBT. This suggests that a therapist is a kind of a technician who ‘administers’ a ‘cure’ to the client, similar to how a doctor might administer an injection or a pill to treat an illness.
It also suggests that psychotherapy is something you can learn in a short training course, and then be allowed to practise. While I do understand the need to enable access to psychological therapies to as many people as possible, I believe it is grossly inappropriate and dangerous to let unqualified people work with people who might have trauma, or some other distress.
EAP companies (Employee Assistance Programmes) contracted by big employers offer a limited number of free counselling sessions to employees (typically five or six sessions) that the employer pays for. Most EAP companies require their counsellors or the counsellors they sub-contract to use CBT, because it is seen as a ‘quick fix’ that can get people back to work as quickly as possible. Remember that in EAP the counsellor works for the employer not for the person who is the end client. It is the employer that pays the bill, not the person who sees the counsellor. So EAP therapists are required to be more ‘loyal’ to the company that pays their bills, not to the people, the clients they work with. There are more than a few ethical issues with this…
Effective therapy in EAP is not measured by whether the client is actually better, but by how quickly they can get back to work and perform at their job. This is regardless of how they really feel, or what else is going on in their life. While it is important for people to do the job they are paid for, if something goes wrong, there are usually good reasons for it. Those reasons, or causes have to be addressed, or at least acknowledged.
How long ‘should’ it take for a person who has lost their beloved spouse, a beloved parent, or a child to feel OK enough to function at an acceptable level? Is there a time limit on grief, and does one-size-fit-all? Well, less than caring employers, and CBT/‘quick fixes’-driven EAP companies certainly think so. Of course, grief is only one example. We all go through many life events, and changes that impact on us.
Either way, focusing only on pushing people to get back to work as quickly as possible does more harm than good. It leads to long-term stress, along with the expected physical problems, and to people taking stress-leave. Just ask around in your workplace how many people are reliant on antidepressant, and other mind-altering medication, and how many people drink regularly… I am not sure how honest people would be if you asked them, but you can try to do your own little survey, and then reflect on what you discover.
My comments below are about CBT when it is practised in its pure form, which usually takes the form of detached/impersonal CBT practitioners handing out plenty of forms for clients to fill in between sessions, checking ‘homework’, and insisting on talking about what the practitioner thinks that the client should talk about in sessions, not what the client necessarily wants to talk about, etc.
Be aware that there are many therapists out there who say they practise CBT, because it gets them contracts with EAP companies or with the NHS. However, in reality they practise better therapies, and only pay lip-service to CBT. If you are going to see someone who says they practise CBT, I recommend that you ask if they practise CBT in its pure form, or if they believe they just incorporate some CBT techniques in their work, but primarily use other approaches.
CBT Is Not Based On Good Science (it is in fact completely unscientific)
CBT is completely out of step with neuroscience, attachment theory, developmental psychology, good science on what really causes depression, or anything we know about how early life experience wires the brain, how it impacts on our psychological development and physical health all through life. In fact, CBT completely ignores all the the good science we have that is relevant to psychology.
CBT, an offshoot of behaviourism, makes incorrect assumptions about mental health:
• that thoughts (cognitions) create feelings
• that there are ‘good’ (healthy) and ‘bad’ (unhealthy) feelings — pleasant or less pleasant emotions/feelings are not the same as ‘good’, ‘bad’, healthy, or unhealthy
• that there is such a thing as ‘faulty’ thinking
• that uncomfortable feelings are a problem to get rid of
• that the most important thing in life, the only thing in life, is to function and ‘cope’ — that our innate growth needs, our profound need for purpose, or connectedness are irrelevant and that all that matters is physical survival.
CBT makes people assume that only nice feelings are OK, and that not feeling good is a sickness (‘pathology’) that has to be eliminated. CBT therapists presume to tell clients that their thoughts are ‘faulty’ and how to think ‘better’ about things, which assumes the therapist knows better than the client what is good or right for the client.
I consider CBT deeply harmful because it leads people away from the neural integration work that is essential for good mental health, development, and recovery from trauma, or other psychological suffering.
CBT constitutes ‘more of the same’. Few people haven’t already tried to push their uncomfortable feelings away, ‘think’ them away, meditate them away, exercise them away, eat them away, shop them away, or otherwise try to manage, or control them? Neural integration, changes to brain connectivity is hat’s needed for a healthy and fulfilling life. To achieve better integration, feelings need to be listened to properly.
Feelings are generated in our limbic system (mammalian brain) in reaction to reality, our life circumstances, 0ur environment, past, present, or both. Feelings/emotions are always an accurate reflection of, or a reaction to our lived experience. Rarely does anyone’s limbic brain malfunction, or produce feelings that make no sense. The only people who have a faulty limbic brain that cannot generate feelings at all are those with antisocial personality disorder (psychotherapy/sociopathy). To treat healthy, albeit suffering people as if they are malfunctioning is not only disrespectful, it is really bad science, and it causes unbelievable harm.
Some feelings are uncomfortable. But whether they are pleasant or not, feelings are nothing more than information generated by our ancient limbic (mammalian) brain that is trying to keep us alive by telling us what’s going on around us. We need this information in order to stay alive, live a full life, manage our adult responsibilities within a complex modern reality, and make good, adult decisions. The more uncomfortable feelings are, the more we need to listen to them. They will not go away until we do. The less you listen to your feelings the ‘louder’ they will get. Feelings are not in themselves a problem, or the problem, no matter how uncomfortable they are.
Feeling bad does not mean that something in your brain is malfunctioning, but there might be something in your life now (or in your past) that does not (or did not) work for you, or is (or was) not good for you. Feelings are a reaction to our environment, past, present, or both. They are the information that tells us about what’s going on in our environment and in our lives, or to something that went on in our past that has had an impact on us and that we might need to start paying attention to. Most people’s limbic brains work exactly as they are meant to. CBT assumes that people are malfunctioning, and therefore tends to reinforce people’s fears about their mental heath, or sanity.
CBT Is Not Real Therapy
Please be aware that by its own definition (!) CBT is intended only for symptom relief. It was never developed, and was never intended for growth or development, or for exploring the past, feelings, life, development, or purpose. CBT is unable to help people work through the underlying causes of their problems. It is only intended to help people function, even if the conditions they live in are wrong, or harmful for them. CBT practitioners are not interested in people’s history or their life’s circumstances. They propose that people can do well and feel good, regardless of anything. This is completely unscientific. It flies in the face of attachment theory and mainstream neuroscience, what we know about trauma and how our childhood environment wires our brain.
CBT might help to cope with something in the short term, but in the long term the problems would still be there waiting for us, and would usually be worse. CBT is really a form of counselling rather than psychotherapy.
CBT does not work not because of you, but because it cannot work. Because pure CBT doesn’t work, it can also cause further harm because it tends to leave people feeling even more like they are failures. Not only do they feel like a failure because they think they are failing at life, they now think they are failing at therapy… People repeatedly tell me that pure CBT programme (filling in a lot of forms and paperwork, recording thoughts and feelings, etc.) feels sterile, irrelevant and boring, and the vast majority of people are unable to follow it.
This is not surprising at all because the brain only grows, develops and changes its architecture in environments where we feel inspired, relaxed, safe, and energised. Therapy is only effective when there is energy and aliveness in the therapeutic process . To feel inspired and motivated, and to feel there is energy in the therapy process the therapist has to be more than a technician, but someone the client can really engage with. In pure CBT the therapist’s job is to ‘administer’ the CBT ‘programme’, not to engage with the client as a real person.
CBT feels dead and deadening to people. But when clients try to tell this to CBT practitioners, or explain that they don’t like to fill in forms, they are made to feel that they are ‘non-compliant’, ‘avoidant’, or even ‘difficult’. A purist CBT practitioner has nothing other than CBT to offer. Pure CBT can therefore cause many people to conclude that their problems are too big or too complicated to resolve, and that they are doomed to feel bad for the rest of their life. Of course this can lead to an even bigger sense of desperation and despair, than the original feelings that send people to seek help in the first place.
CBT and Trauma
CBT can be especially harmful for people with trauma, because it focuses entirely on the inside. It ignores the complex context of trauma, and what caused trauma in each individual. It reinforces people’s belief that trauma is their fault, and that regardless of what had happened to them or what was done to them, they should be OK. (See this brilliant TED talk by Dr Nadine Burke Harris who explains how Adverse Childhood Experience, ACE, affects our brain)
In CBT the therapist is not interested in anything to do with the client’s history and pure CBT practitioners have no training in processing the difficult feelings, or emotional and physical flashbacks that people with trauma can experience in therapy and in their life in general. In fact, they would consider these to be the problem and see flashbacks and emotional triggers as an unwanted distraction… I have had clients who were told by pure CBT practitioners that they should not express difficult feelings in sessions, and that there was no room for these emotions in sessions…! People with trauma already tend to feel that their problems are their own fault. and CBT reinforces this message. (To read more about this, see a link to my trauma booklet below).
The vast majority of people are capable of much more than just symptom management. Most people are able to change the architecture of their brain — something we do each time we learn something new — in the ways necessary for growth and development and for moving towards a more fulfilling and satisfying life.
Here is what the great Existential Psychotherapist Professor Irvin Yalom has to say about CBT: “Yalom … expressed regret that so many new counselors work in environments that focus solely on cognitive behavior therapy (CBT) because it is labeled an evidence-based model. “CBT omits the essence of psychotherapy — the interpersonal nature of the therapeutic relationship …” (Full article is here)
And this too: “Someone’s got to do some more research, but I would really like to know: when a CBT therapist really gets distressed, who does he go see? I just have a strong sense it’s not another CBT therapist. I think he wants to go out and search for somebody who’s wise and can help him explore deeper levels. There’s probably psychotherapy research out there that I haven’t read, but it would be interesting to know that. If you come across the data let me know. I certainly see a lot of them in therapy.” (Full interview is here)
If you want to read a relatively recent and good book on CBT, and have the brain space for a scholarly book, I recommend Dalal, F. (2018). CBT: The Cognitive Behavioural Tsunami (Managerialism, Politics, and the Corruption of Science). London: Routledge.
Humanistic and Existential Values and Principles in Psychotherapy and Psychology
My core values are humanistic and existential (CBT is based on anti-humanistic/anti-existential values and principles):
Among other things, Humanistic/existential therapy is based on:
- A sense of equality between the therapist and the client. We are all human, and all deal with similar difficulties and challenges. A good therapist shouldn’t be ‘playing a part’ in the therapy process, but be real and engage with clients as a real human being;
- The idea that most people already have the answers or insights into their problems. Nine times out of ten people already know what is going wrong with them. They just need the right environment to support them in getting clarity, face what they need to face and be offered ways to experiment with different ways of being in the world;
- The idea that people should be met exactly where they are, and that they need to be validated in their unique, subjective experience of their life and their inner world.
- The idea that the client, not the therapist is the expert on the client’s world and life;
- The idea that everyone has a need for their life to mean something. People need purpose, and life has to be about more than just ‘coping’ or surviving. No human being does well psychologically and emotionally if all they have is a life that is focused on survival and on coping, and when they have little opportunity to fulfil their purpose or potential. Psychotherapists must be interested in their clients’ need for purpose and therapy has to facilitate a movement towards a full and fulfilling life. Psychotherapy is not another way to stick a plaster over problems, or help people find better ’strategies’ to just ‘cope’ with an unfulfilling life that is hurting them.
- The idea that to be effective and useful to people, psychotherapy has to be seen as a developmental process. The purpose of psychotherapy is to restore people onto the path to optimal development towards their full potential; the path they would have been on naturally if everything in their childhood and life was perfect.
- The principle that feelings are not an enemy to get rid of but are a valuable source of information about what is going on with us. Difficult feelings, ’symptoms’ are a pointer to where the real problems are. They are not something to ignore or banish.
There is more of course, but I think this is a reasonable summary of the main principles behind humanistic/existential psychotherapy.
Effective and good quality psychotherapy from a humanistic/existential perspective often leads to people making important life-changing decisions. I regularly witness big decisions and life changes that my clients initiate when they are ready. Sometimes it is necessary to make life-changing decisions, in order to ensure that the way we live is aligned with what we feel is a more fulfilling, wholesome, and authentic way to live. A good therapist would never push a client in any particular direction. A good therapist is a facilitator who supports his or her clients’ natural developmental process so they can make their own choices and move in the direction they need to move.
Please Be Aware:
• I do not offer therapy by phone, email, Zoom, Skype, or any other remote method to new clients. This is only available, very occasionally to clients who I already see or have seen face-to-face, in certain circumstances when they can’t make it to a face-to-face appointment.
• I do not offer symptom management or ‘techniques’ to manage emotions. My practice, which integrates many modalities and principles within the framework of Interpersonal Neurobiology (IPNB), focuses on the real work that needs to be done in order to grow and develop. Symptoms begin to disappear as a byproduct of real and effective psychotherapy. What I pursue is integration (growth), not symptom reduction or management.
• I do not offer techniques like EMDR, hypnotherapy or EFT (the tapping technique). Nor do I offer shortcuts, tricks or ‘quick fixes’, simply because there aren’t any. Anything that promises to re-wire the brain quickly is out of step with how the human brain works, and how it learns. You cannot ‘fix’ psychological difficulties overnight, for the same reason that you cannot learn a new language or skill overnight, no matter how hard you try. Change to any aspect of our being means changes to our brain connectivity, and structure. The human brain takes time to wire and re-wire itself. When we learn anything new, getting better at something requires the right information, practice, repetition, and reinforcement. Therapy facilitates all of this, but focuses on the brain systems that are relevant to our psychological wellbeing.
• Psychological wellbeing depends on brain connectivity. Everything in the brain works according to the same principles. Neurones connect when they fire together repeatedly. They then form permanent neural networks in the brain that contain whatever it is we are learning, and it becomes a part of who we are (‘second nature’). In therapy the connections we need are between the executive brain — our most modern brain — and our ancient limbic brain where our feelings are generated. Real and lasting change takes time and a great deal of practice.
• Therapy often takes a bit longer for people who suffer from the effects of early trauma. This is not because they are stupid, but because their brain has more to do and more to integrate than people who are fortunate enough to not suffer from the impact of early trauma.
• Practice of the right emotional skills (and there is right and wrong when it comes to emotions!) leads to neural integration between our executive brain and our limbic brain. Better neural integration is responsible for what we think of as good mental health, healthy self-esteem, healing, maturity, confidence, healthy boundaries, feeling grounded, fulfilled and peaceful. Therapists play an extremely important part in this if they offer a lively and energetic engagement and help clients process (meaning join up neurones) in a safe, creative, intelligent and supportive environment. (If you want to read a bit more about this, take a look at my short books, which are part of my Fully Human Tools For Life Series, which cover a number of topics in mental healthy. Therapy Without A Therapist focuses specifically on how therapy works and what we do in therapy. You might want to read it before you make an appointment with me if you want to be sure that you are making the right choice).
• About Facebook — Because of professional boundaries I don’t ‘friend’ clients on my personal Facebook page. (To learn more about professional boundaries please look at the Ethics page on this site.) Clients and members of the general public are welcome to ‘Like’ and post questions or comments on my Fully Human Facebook page.