Recovering from Burnout through Therapeutic Conversations

Beating the Psychology of Isolation

Often when people meet with me for online counselling or therapy, one of the first things they tell me is how they are ‘lost’…

I don’t know where to go

I’ve lost direction

I’ve lost touch with who I am

Popular psychology promotes concepts such as ‘independence’, ‘self-improvement’, ‘inner-strength’ and ‘self-actualisation’. As a result, many people think they must find the way forward on their own. There is a whole industry of self-help books, audio recordings and DVD’s that are marketed with this in mind.

It is a nice idea, and sometimes it works for some people. But perhaps it also has the potential to leave us feeling isolated and alone. And this may actually be contributing to the problem of being lost!

For example, when we venture into unknown territory or explore an unfamiliar place, we are probably more likely to get lost when we are on our own than when we are in the company of another person whether they be a trusted friend or experienced professional. It might be even worse if we don’t have a map or have forgotten where we were going.

Responding to Burnout with Recovering Conversations

It can be like that with life as well. When people come to meet with me in my capacity as a therapist, they have usually tried many ways of reorienting themselves or getting back to the person they were before. They are often at rock bottom or feeling burnt out and talk about coming to see me as a last resort. For certain people, this takes form as a Mid-Life Crisis, but of course it can happen at any age… it doesn’t need to be when we are middle aged!

So how can another person play a role in helping us to find our way forward again?

My experience, both personally and professionally, is that having a conversation can open up possibilities. Talking about where we have come from can help us to recognise the familiar landmarks of our lives. These might include, for example, interests we once had, books, films or sports we were passionate about and values we hold. We might recall having a previous sense of our identity through our own eyes or those of a friend, family member or former mentor. A therapeutic conversation can help us to recover an understanding of what was, and possibly still is, important to us.

Collaborative Counselling and Finding Direction

Once we have some familiar landmarks, once we have our bearings, we can ask ourselves where we want to go or at least try to remember where we thought we were headed when we became lost. Again in collaborative counselling, this is a kind of Recovering-Conversation. Talking about directions and choices with a counsellor can be like having a sounding board for the options we are considering or an audience for acknowledging how far we have actually progressed to date.

In this way, the conversation becomes a map (especially if some of the significant points are documented for later reference), recovered values become guiding lights and the therapist becomes a co-navigator. Together we can construct meanings out of experiences and events and these meanings can act as signposts. A series of counselling appointments turns into a pathway to a better place.

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Consultations in London in November 2010

Counselling Therapy in London

Face to Face Counselling in London

Ash will be available for face to face consultations in central London 22-23 November. If you would like to meet for a therapeutic conversation , send an email or leave a message on the London number.

Online Counselling

You can continue from this counselling appointment with online therapy via webcam, email exchange or instant message chat.

Advice or Therapy? Taking a Collaborative Approach with Your Therapist

People are always asking me for advice. I regularly receive requests over email, via my websites and even on Facebook asking me for advice or direction with particular problems or difficulties. Often these requests are for relationship advice, or advice about how to find confidence or how to develop ‘communication skills’.

It is not unusual for someone to write tell me what to do! I read all of these requests but have to admit it is rare that ‘answers’ instantly come to me. On the other hand, I am always struck by the curiosity and interest that arises in me and my respect for the person who is looking for a way forward.

Experts in Our Own Lives.

I guess the assumption is that as a therapist, I have knowledge and experience that qualifies me to tell people what to do. Those who contact me assume that my profession means that I will be a better judge of their circumstances than they are, or at least that I will have more insight or skill with the particular problems or situations that take shape in their explanations. But advice is something I am reluctant to give. While I’m not suggesting that having started out as a counsellor over 20 years ago counts for nothing, I would not say that my experience makes me an expert in anyone’s life but my own.

Many of my colleagues would agree with me. Much professional counselling and therapy has moved a long way from the 1950’s when psychodynamic psychology and psychotherapy located the source of problems within the individual seeking treatment and promoted the therapist as the authority, master or even ‘guru’ in matters involving human dilemmas. Fortunately, the therapist’s status as expert in the lives of others is now being questioned.

The Limitless Possibilities of the Therapy Space.

It is true that most therapists and counsellors are trained in particular theories and even encouraged to ‘diagnose’ problems and fit them to these theories. Therapists are considered qualified to know how to respond to ‘types’ of problems be they problems associated with Depression, Anxiety or ‘relationship issues’ etc. However, taking such an approach neglects one of the most exceptional aspects of therapy: therapy as a collaborative activity can create a space where extraordinary things happen.

When a collaborative approach is taken to therapy, multiple understandings can co-exist, new meanings and understandings can evolve and language and the exchange of ideas can open the way for limitless possibilities. Advice-giving, in contrast, is a fairly one-sided process. Therapy is not just listening and it is not advice-giving. At its most exciting and influential, it is a collaborative process which gives us the opportunity to demonstrate and experience the expertise we have in our own lives.

How Collaborative Therapy Evolves and Dissolves Problems.

Collaborative Therapy is about participating in conversations that open up possibilities and ideas. This happens through dialogue and exchange of descriptions we give to things. When we put language to our experiences and to our hopes and intentions, we start to construct meaning and understanding. When we do this in a therapeutic context, we can become collaborators with our therapists in the construction of new and preferred meanings and understandings.

We create our understandings of problems through the language we use. People often talk about therapy giving them a new perspective. As much as I would like to claim credit for handing out new perspectives, I don’t think this is how it works in the conversations I have with people. New perspectives evolve from the dialogue, the conversation in the therapy space, whether in online therapy, a conversation with a therapist in the same room or a group therapy situation. New perspectives help us take the next steps forward and foster hope.

In therapy, like in other conversations, there is usually not just one way of looking at things. Like anyone else, I might have an opinion about a given situation as it is described to me. But as a therapist I am concerned to open the way to new meanings and understandings and continue dialogue, not close down understandings or impose meaning. When problems are defined collaboratively in this way, it is not surprising that the definition of the problem can change over time. Likewise, the therapeutic effect of conversations often continues even outside of the therapy space. Problems gain new and preferred meanings and understandings through talking about them with therapists and others. Problems are not fixed or solved by the therapist, but evolved and dissolved in conversations.

I’m not against advice. I particularly remember the advice certain people have given me at different times in my life which I am grateful for and continue to hold close to me. Advice can be useful and lovely. But therapy and advice are not the same. Collaborative Therapy offers us the opportunity to contribute our own expertise to conversations, open up new meanings and possibilities and find our own ways forward when advice is not enough.

I am indebted to Harlene Anderson for many of the ideas in this article.

For more information or to make an appointment go to www.forwardtherapy.com

8 Ways to Recover Yourself from Burnout

What is Burnout?

Burnout can present itself differently for different people. Someone who usually describes himself as “laid back” or “chilled out” may say he is “on the edge” or “uptight”. Others might talk about the numbness of Burnout or say they feel like an empty shell.

Sometimes people use the word ‘depression’ to convey what they are going through. Feelings of anger or sadness can be increased. Many say they are “unable to switch off”. Common factors for Burnout appear to be the loss of enjoyment of life, a disinterest in usual activities and physical and mental tiredness. Many say things like “I’ve lost touch with who I am”.

Burnout can result in us losing connection with our friends and family and withdrawing into ourselves. It can have us avoiding people and activities we enjoy such as going out or having sex. But the reverse can be true as well. The consequences of Burnout may be the spiral into a more chaotic life if someone is unable to face certain responsibilities or perceived expectations. We may find it harder to say ‘no’ or ‘yes’ to choices that are presented to us. This can lead to increased use of alcohol or drugs and these in turn can also be contributors to difficulties of Burnout.

Burnout is most often associated with overworking. But it can also happen while making the transition into a new job or new responsibilities (including becoming a father or mother for the first time or caring for a sick relative). At these times, we can find ourselves in situations where the expectations on us are just too high and unrealistic. In modern life and corporate culture where there is so much emphasis on performance, achievement and attaining materialistic goals, the public realm of our lives can easily take precedence over the private. Caring or meeting the requirements of others can easily take over from caring for our selves.

How Counselling Can Help with Burnout.

When they start seeking help for Burnout, most people just want to start feeling like their old selves again. Therapeutic conversations offer the time to reflect and an opportunity to gain understanding through a joint investigation of the problem.

Counselling can be like a reality check and a skilled therapist will not only allow you to release some of your feelings but assist you to re-establish connections to your values, beliefs and most importantly your sense of who you are. Who are the people who are most important in your life? Where are you in relation to these loved ones now and how might you return them to their rightful place in your life?

Attending counselling can provide stability in times of crisis as well as remind you of strategies you can use to switch off from responsibilities and expectations when you need to. Often, just talking about what is realistic and what is possible can clear the way for a fresh start. Burnout can leave us with a story of failure but a therapist can draw out other stories that are more positive and inspiring.

Narrative Therapy is geared towards recovering a deeper sense of meaning to life and resetting priorities so they are more in touch with your own principles. Before we can reclaim a sense of who we are, it may help to share what it was that we valued about our lives before Burnout. A counsellor can enquire into this and help you develop your own understanding of the best ways forward.

8 Ways to Recover Yourself from Burnout

1. Ask for support from colleagues and those you love.
2. Place limits on what is asked of you and how much you do yourself.
3. Discard unrealistic expectations.
4. Reframe ‘failures’ as achievements.
5. Make firmer boundaries between work and private life.
6. Create a sense of ritual around regular activities that you enjoy.
7. Remember to play.
8. Book a therapeutic conversation with a professional counsellor.

For more information or to make an appointment go to www.forwardtherapy.com

What is Sex Addiction?

Recently, there has been a lot of discussion in newspapers and on television about sex addiction. Stories about celebrities such as Tiger Woods and David Duchovny have raised interest and debate amongst health professionals and the general public. Many people who are struggling to make sense of things of their lives have been asking themselves whether their own problems might come down to something called ‘sex addiction’.

The Problems with Calling Something ‘Sex Addiction’.

But there are a few problems with this idea of sex addiction. To begin with, what actually is addiction? Is it a behavioural pattern? Is it a brain disorder? Something to do with chemicals in the brain? Is it treatable or untreatable? Because there are numerous definitions of addiction it can be very confusing for someone who starts thinking of him or herself as “an addict”.

Another problem with this idea of ‘sex addiction’ is: what happens to responsibility when someone starts thinking this way, that they are an addict? Does having an addiction mean a person is not responsible for his or her actions? Could sex addiction become an excuse for doing something that goes against a persons own values and beliefs?

And probably the worst thing about this idea of sex addiction is that it makes people feel bad. If you start thinking of yourself as a ‘sex addict’ you will probably start believing you have a disorder or that you are sick or not normal. In a therapeutic context, this is often called the ‘internalising’ of a problem. The problem – interpreted as ‘sex addiction’ in this case – has you thinking there is something wrong with you and you are the cause of it. Understandably, these kinds of thoughts can make a person feel quite shameful. And shame often traps and makes them afraid to talk about problems. So the problem becomes bigger and more influential than it was before.

So if sex addiction isn’t the problem, what is?

Good question!

If you have contacted a therapist or counsellor wanting help for ‘sex addiction’:

• You might think you are having too much sex or want to stop or reduce the amount of sex you are having,
• You might be having sex with a person other than your usual partner and without your usual partner’s knowledge,
• You might be taking risks with sex you would not usually take,
• You might feel bad about the sex you are having,
• Or perhaps several or all of these apply for you.

In other words, there is a range of situations that lead people to get an idea they may be experiencing sex addiction. There are also many reasons individuals find themselves in these situations. For every person who believes they may have a ‘sex addiction’, there is a unique story behind their arriving at this understanding.

People are more than just machines or animals: we are meaning makers. We are constantly making meaning about our lives. And these meanings are connected to our culture and history. If a therapist focuses on sex alone as the problem, and doesn’t explore the meanings you have and can make, they risk failing to understand what is most personally important and relevant to you. This idea of treatment for sex addiction can actually be obscuring many other details that factor into what is affecting you and what you would prefer for your life. Furthermore, the idea of ‘sex addiction’ probably has you believing any problem (whatever it may be) exists within you, instead of in a particular circumstance or relationship you are involved with.

How Can Narrative Therapy Help?

Asking this question ‘what is sex addiction?’ is one way to begin investigating the problem or problems that might be hidden by the idea of sex addiction. There are many ways of proceeding in a therapeutic conversation that questions this idea of sex addiction.

• Where have you heard these ideas about sex and sex addiction?
• What has been going for you that has lead to these ‘sex addiction’ thoughts?
• How might these ideas about sex addiction and these thoughts of sex addiction be connected?
• What is it about the sex that you are having that concerns you?

We can investigate how these thoughts of sex addiction have been constructed. We can explore your hopes, values and beliefs through considering the circumstances that have brought you to therapy. Once we have some new ground to stand on, these ideas about sex addiction often become less relevant than your intentions and the efforts you have been making for what you want in your life.

For more information or to make an appointment, go to www.forwardtherapy.com

Using Life Metaphors in Gay Counselling & Psychotherapy

I work a lot with metaphors and many of my clients are gay men and lesbians. The approach I use in counselling and psychotherapy is based on the principal that we interpret and make meaning of life through the stories we tell ourselves and others. These stories about the events and the experiences of our lives employ metaphors.

The journey metaphor (life as a journey) is very common in counselling work as are pedagogic metaphors (life as learning). But rather than come up with the metaphors myself, I am interested in the metaphors people bring to the counselling session. As a therapist I do not set about making interpretations but assist people to make their own interpretations.

For example, say I am meeting with a client who talks about not being able to find any satisfaction in life. He has been searching for satisfaction for a long time. He knows it exists because he knows some other gay men who seem to have found it, but he was always told when he was growing up that satisfaction came from having a family and finding a loving partner. He hasn’t been able to find satisfaction and has often thought about giving up (the giving up took the form of suicidal thoughts), but something leads him to keep pursuing it.

This story could be seen as a kind of a quest metaphor: the quest for satisfaction. In telling me the story of this search he uses words like ‘finding’, ‘searching’, ‘existence’, ‘giving up’ and ‘pursuing’.

So I can pick up this metaphor and start using it with him, using his own language and interpretation of the events and experiences of his life to find new clues, signposts etc to explore the origins of this quest with him. Quest metaphors are not uncommon of course and we see them regularly in films such as The Wizard of Oz, and Lord of the Rings etc.

Someone else might come to me with a problem of ‘not knowing how to make friends’. So there is a metaphor here in the ‘making’. This person has ‘almost given up’ because it requires ‘too much effort’ and he has ‘nothing to see for it’. When I ask about what he has heard about making friends he tells me that he understands it takes ‘Time, Trust and Effort’. And from his experience already he has decided that it is quite ‘hard to build on one night stands’ or ‘random hook ups’ because the whole thing is liable to ‘come crumbling down’ too easily.

This sounds to me like a construction metaphor. I can follow this up with him by asking about plans and dreams of what kinds of friendships he wants to build. Are they great edifices or cosy hideaways? If random hook ups don’t seem to work, what sort of foundations might work? What is the cement of friendship? What are the building blocks? Does he know of any ‘finished products’ or ‘works in progress’ he can get ideas from?

I find metaphors really stimulating. Firstly, I don’t come up with them, others do, but I can help develop the preferred story and plotlines. Metaphors also speak to the hopes, beliefs, commitments and values people have. And hearing about these is just as important as hearing the problem story.

For more information or to make an appointment, go to www.forwardtherapy.com

A Conversation about Anxiety using Narrative Therapy.

Anxiety is one of the most pervasive problems that people present with for therapy and counselling. If you have a problem with Anxiety, you are certainly not alone!

Research has shown that anti-anxiety medication should not be used long term for anxiety due to potential side effects and risk of addiction.

Talking therapies, such as Narrative Therapy, provide an alternative treatment for managing or overcoming anxiety, depression and other mental health difficulties.

Anxiety often has people identifying strongly with it. A person may turn up to therapy and say, “I am an anxious person”.  They may even go so far as to say “I am Anxious”. It is as though the person and the problem have actually become one! With this comes an expectation that a person needs to be ‘fixed’ or ‘corrected’ in some way.

Narrative Therapists know that people are not problems. While a problem can become highly influential in someone’s life, there is always more to a person than the problems he or she is experiencing. One of the first things we can do to make this difference more obvious is to try to externalise anxiety. For example, we can start to explore descriptions of the anxiety. The richer and more vivid these descriptions, the better.

Person: It’s strong. It’s tough. It has a hold over my life.

Therapist: A hold over your life? Like it has you trapped?

Person: Yes, it’s keeping me prisoner. It keeps me trapped in a very dark place.

These questions and answers serve to raise the curiosity of both the therapist and the person attending therapy. There are many directions in which a therapeutic conversation can go and this is just one example…

Therapist: What is Anxiety keeping you prisoner from?

Person: Well I used to love going shopping, but the anxiety makes me dread going out where there might be lots of people. Parties as well. I’d like to make more friends but when I go out I just get so anxious.

People are not so used to externalising and the idea that problems are located within us is quite widespread. So it helps to have a therapist continue to speak of anxiety as having its own character.

Therapist: So Anxiety traps you away from the things you enjoy, shopping, parties, meeting people and things like that?

Person: Yes. It takes away my pleasure.

Therapist: Would it be fair to say Anxiety robs you of pleasure? Or would that be the wrong expression?

Person: No, that’s fair. It has robbed me of pleasure. It gives me insomnia so it’s also robbed me of sleep. It’s been around a long time.

Everyone affected by Anxiety has a unique relationship with it. We already know this particular Anxiety as a kind of forceful captor that keeps this person away from enjoyable activities and steals their pleasure and sleep. Other questions can be used to investigate what the person retains of their identity.

Therapist: What does this Anxiety stop other people from knowing about you?

Person: It makes me seem unfriendly and people get the idea that I don’t like making friends. Nothing could be further from the truth! In fact if it wasn’t for Anxiety I think I might have a lot more friends.

Therapist: Really?

Person: Yes. I’m actually a nice person. But the Anxiety keeps this hidden.

As new strands of the story are revealed, new opportunities to explore the tactics of Anxiety present themselves…

Therapist: What strategies does Anxiety use to try to keep this niceness hidden?

Person: It talks me out of doing things. I might have every intention of going out to a family get-together but Anxiety tells me it will be too hard and I start to panic.

Narrative Therapists are always listening not only to the story of the problem but to the stories of resistance or resilience or action against the problem.

Therapist: Have there been times when you have stood up to Anxiety and refused to listen to it?

Person: Yes there have, although there are not many.

Therapist: Can you tell me about one of these times? What did you do?

Sometimes there are exceptional moments in a person’s life when a problem like Anxiety does not have its way. Such a story may provide memories of skills and abilities or beliefs or values that are important in finding a way forward. Unlike many therapeutic approaches, Narrative Therapy is a form of psychotherapy that does not treat people as disorders or as deficient but as sources of knowledge and holders of experience.

These are just possible initial directions in a conversation about Anxiety. This kind of initial exploration might take place over 1 or 2 sessions with a psychotherapist, psychologist or counsellor. It might assist someone to regain a sense of who they are and discover more about themselves in the process.

For more information or to make an appointment, go to www.forwardtherapy.com