Psychotherapy : Counselling : CBT
Harley Street, London
Tom Buckland : Counselling & Psychotherapy
Tom is based in Hythe Hampshire, and also central London.
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Being in Therapy:
To protect confidentiality around this person, this case has had all identifying details removed. It gives you and example of how therapy can be, although all therapy can be different in the amount of sessions and type of approach. And it has to be said different people get different results from therapy, but by committing to it, and carrying out work between sessions, this is often a factor for results, and Paula worked really hard through her journey.
Paula was a 37 year old woman who originally came to me for a general anxiety. She said she had always been a worrier, and was now finding her anxieties were increasing. She had a job interview in 3 weeks time, so she wanted to work towards feeling more relaxed and more confident over this and also reduce her general anxiety in her life.
When she entered the room she seemed nervous and unsure and found it difficult to make eye contact, but relaxed more as the session progressed.
The first session gave Paula more time to tell me about her life story and talk about her anxieties. We then made a plan on the best way to help her.
Sessions 2 to 5 were looking at coping strategies to help her in this way. We explored breathing techniques to help her calm herself, and how to change her thinking patterns that were constantly making her feel worried and anxious. Then we explored the use of exposure therapy where she could gradually challenge her feelings and face the situations that made her feel anxious, and do this a little at a time. For example, she said she wanted to go out with her girlfriends, but the thought of the night out make her feel anxious. We made a plan that she would try going out for an hour instead of the whole night, and gradually over time to build this up to 2 hours then 3, and eventually the whole evening.
This type of therapy would be classed as solution focused counselling
By session 6 the things she had put in place had started to make her feel more in control. She had more understanding of what anxiety is, and some coping strategies to put in place that can gradually changed her thinking patterns and reduced the anxiety. She felt that she was now in a position to overcome any anxieties.
She had asked me how many more sessions she needed. I said as regard the anxieties, maybe 1 or 2 more, but……..
One of the strong skills of psychotherapy is for the therapist to notice what is happening in the room, and at the right time, to feed this back to the client to help them get a better understanding of themselves, and help them to grow as a person. At this point I fed back to Paula that I had noticed a few times she had mentioned her mum and said they get on well, but each time she said this to me, I noticed she clenched her hands tightly and I wondered if they really to get on that well. I also said I noticed she worked hard to try and please me by always saying how hard she had worked at her tasks set between sessions, and always mentioning how stressful my work must be, and she didn’t mind if the session ended 5 minutes early as it would give me more time to have a ‘cup of tea’ afterwards, and I wondered if she worried about pleasing other people?
With this she burst into tears. She said although she loved her mum, whenever she saw her they ended up arguing and she then felt angry, sad and tearful for days after.
She also said her husband at times accuses her of being needy and always fussing over him. She said she would like to change but wouldn’t know how.
I explained how longer-term psychotherapy might help. This would be different to the solution focused approach we had been using, and give more time and space to develop an understanding of herself and her behaviours at a deeper level. She could continue to use what she had already learnt around the anxieties, but this will help her in other areas of her life.
Paula agreed and seemed relieved that she had been able to talk about this.
For the next 3 months Paula had weekly sessions of Psychotherapy. In this we explored her personality, her dreams, her childhood, and her aspirations. Gradually she realised that she had always wanted her mum to say ‘well done’ but had never experienced this, so without realising, as an adult she constantly tried to get approval from people so they did this and made her feel better, and she could see this influenced how she was at work and around friends. She realised that her arguments she had with her mum happened because when she was in her mum’s company, her inner child was desperate to get her mums approval, and the adult was angry that it wasn’t being given. Her mother was unaware of the inner child's hurt, and only reacted to what she saw, her adult daughter being cold and defensive toward her.
Paula also learnt other things about herself. She realised that her dad was always critical of people with money, and all through her life she had sabotaged any work opportunities that took her over the earning threshold that her dad had decided was ‘wrong’, and unknowingly, she had feared letting her dad down by becoming one of ‘those’ people.
As the weeks went by, Paula, with being able to express all this inner turmoil, started to feel different. She realised her mum never really knew how to be positive to her, and this may have stemmed from her own upbringing rather than it be anything to do with Paula or who she is. Two months into therapy she come into a session excited to tell me how she had gone to see her mum and ‘somehow by magic’ they had spent 4 hours together without arguing, and Paula had enjoyed being in her mum’s company.
At the end of the therapy Paula was much happier and calmer and the anxieties had drastically reduced, as she had connected the fear of being judged by her mum when she was young, had then developed into a fear being judged by anyone as an adult. She now saw her parents in a different way, and reported she had let go of anger she didn’t even know was there.
There is always more therapy that can be done, but we felt for now, she had achieved so much we set aside a last session to end what had been a difficult and sometimes tearful journey, but one we both felt was an uplifting and a worthwhile one.
I sometimes wonder how Paula is, but knowing that therapy was a good experience for her and remembering how she was when had first entered the room at session 1, and how much more confident and self-assured she was when she left at the end of the last session, makes me feel proud and how worthwhile this profession is.