Counselling and Psychotherapy in High Wycombe, Buckinghamshire
I am a UKCP registered psychotherapist and counsellor working in Hazlemere, near High Wycombe, in Buckinghamshire. Before starting in private practice I trained in the NHS at St Barts' Hospital in London and before that at the Homerton Hospital in Hackney. I have 15 years experience of working with people dealing with depression, low mood, anxiety states, trauma and bereavement.
I work on both a short and long term basis with people who are trying to work through a variety of situations and problems. Sometimes relating to a specific event such as bereavement, divorce or redundancy, sometimes relating to a more general problem or behaviour.
My psychotherapy and counselling practice is based at 212 Amersham Road, Hazlemere,(near High Wycombe), Buckinghamshire, HP15 7QT
Telephone: 01494 521311 Mobile: 07980 750376
I am a member of the Association of Independent Psychotherapists, I have an MA in Psychotherapy & Counselling, I am a supervisor, and I work to both the UKCP and the BACP Code of Ethics.
If you would like to arrange an initial consultation to talk through some of your feelings, thoughts, concerns or hopes, you are welcome to contact me. I charge £50.00 for an initial consultation.
I also offer supervision services for qualified, and training, psychotherapists and counsellors.
Registered with Counselling Directory.
Registered with the Association of Independent Psychotherapists.
For more information visit www.tobyingham.com.
Psychotherapy blog click here
Today's blog post: Overhauling mental health provision
Reading of Theresa May's interest in overhauling mental health provision (BBC 090117) made me think of the need to try to address mental health issues before they become too developed. Ideally we would all be better at spotting signs of distress in our children, or in children we care for. The things we identify in children's behaviour, perhaps issues around toilet training, engagement with other children, aggression, or a tendency to withdrawal, might lead us to wonder more about the emotional wellbeing of those children.
This is because our emotional issues, our mental health, tends to have something of a career. So for example we might see children start to act out more socially destructively as they grow up. We might see signs of more aggression, perhaps of truancy, shop lifting and so on. The question might be what do we do with these signs, with the things we observe? Do we do anything about them?
We may have grown up with parents and carers who were themselves quick to turn a blind eye or who just were not very sensitive to the needs of others. We might find, when we look more closely at our family histories that there was something of a lack of care in their lives, and when we come to reflect upon it we might see as that this has had an effect upon us.
Mostly we don't just suddenly wake up as adults with mental health issues. We travelled to the mental states that we now start to realise we have arrived at over a period of time. Mostly we can see that those issues and character traits have a longer history.
So if there is now to be an attempt to deal with the “hidden injustices” of mental illness I hope that they will include a greater consideration of early care.
December 2016: Addressing addiction based issues
Sometimes you have to adapt to deal with addiction based issues. In the first place it is necessary to stop the addictive behaviour. The addict needs to break the destructive behaviour before it can be more thoroughly thought about and understood. Otherwise the good work that is done in therapy will quickly be undone by an addiction driven episode of behaviour, and the therapy will lurch from having to handle the fallout from one episode after another. Before the therapy can progress it is necessary for the addict to break their addiction. It may be possible to utilise ideas and techniques from 12 step programmes to do this.
People struggle when it comes to breaking addictions. They might have experience of going to 12 step meetings such as Alcoholics Anonymous or Families Anonymous, but may have found the meetings off putting.
I worked at a private treatment centre in Marylebone and before that at Promis treatment centre. I think it can often be helpful to have a one-to-one confidential conversation with someone with experience of working with addictions. It can help you to understand how you might use a 12 step programme to support the changes you are looking to make. Such programmes can look strange and off putting at first, but they can be very useful and, they are free.
Once the addictive behaviour has been brought under control and life starts to become manageable, then the therapy can better engage with the issues that underly the problem.
November 2016, What is realistic?
People can have an idea that a psychotherapist or counsellor will quickly make inspirational interpretations of their situation and that their lives will be changed very quickly. I think this is unrealistic.
What is possible is that through working with a therapist or counsellor you may develop a sense of trust and confidence in them and so be able to develop a therapeutic relationship.
In time, this work may enable you to explore your situation further, and so assist you to start to make links between your memories, thoughts and feelings.
You may find that by doing this you develop an interest and confidence in working on the things that bother you about your life, and that doing this improves your situation.
November 2016: Seizing the moment to make a change
It is one thing being able to recognise the moments in our lives when change is possible, it is another being able to follow that through and make change happen. Most of the time we tend to live life going through a series of repetitions. We walk, as it were, paths long familiar to us. What once started out as a new step into unknown territory has long since changed into a habitual routine. In lots of ways this may work well for us, making sure we get to sleep at the right time, don’t drink too much, and so on. There are useful habits, but, equally, you may recognise there are certain things you are missing out on, and that sense of missing out may become hard to bear. If that is you, then finding the time to explore your options, to see what changes you might start to make is important. But how do you start? How do you follow that impulse through?
When we have become so used to doing the same things it makes it hard to find a way to do something new. So it is difficult, but, somehow, we need to find a way to spot our need to change, and act upon it. If we can do this it is as though suddenly a door opens and we step into new possibilities for living. Like a bird came and sang at your window and you decided to open the window and listen to it instead of turning away.
We might recognise that such moments occur, but can we take the opportunity to follow them before the door closes, before the bird stops singing and the moment is gone? There are some moments that have to be seized when they occur, it is not possible to create them again, if you miss one you may have to wait ages for the next opportunity. I often meet people who have come to such points. They come to speak with me about making changes in their lives, and they know it is important to do so. They arrange sessions and duly start to explore questions they may have been harbouring for a long time. But it is not uncommon that they lose momentum, the strangeness of doing something new is too disconcerting. The moment has passed, something changes and what one week was a viable possibility is gone again, and they slip back into the pattern of their lives without changing the thing they wanted to change. And actually in the short term they can feel better because they have stopped talking about difficult subjects like change. Suddenly the moment has passed and they experience the momentary relief of walking the familiar paths of themselves again. They have a temporary sense of improvement but in the longer term have not changed the thing they hoped to. And, at some unknown point in the future they will try to find a way to start all over again. Bit of a shame really.
19 September 2016; Questions for mid-life: How do I go about changing the way I live?
We may have the feeling that we want to change something about the way we live but do not know how to go about it. To an extent this is because we live inside the problems we are trying to escape from, so from that position making changes, even seeing what changes might be like, is difficult, if not impossible. Making a meaningful change to our psychology and emotional well being involves changing and often breaking out of the world we are living in. How are we supposed to do something as challenging as that?
An image comes to mind of frontiersmen and women, explorers who made real geographical journeys because they knew that staying where they were was limiting and possibly dangerous to their own ongoing survival. So they travelled, to the west in search of new worlds and possibilities. These journeys were often dangerous but they knew they had to try to make them, not only for themselves but for their hopes for the future and for their children's lives to come.
I use this image to make a point. Thankfully we may not have to think of getting the wagons ready to roll, in psychotherapy we have an alternative. The fact that you are frustrated that you are going round familiar problems again and again, I take as a sign that something within you is calling for a change to be made. Change is needed, you know it yourself and to my mind there is a real opportunity in this knowledge.
When I work with people I do not try to suggest or force my own ideas of how they should be living, rather I try to engage with them and with their frustrated feelings. In my work I try to help people find a way to engage with their own wish for change, and try to help them clear some space for that change to make itself felt. The more we can find out about this wish for change, the more life and energy we may be able to give it, and that bodes well for making the longed for changes. The fact that you find yourself going round this mood and feeling for the umpteenth time is a real sign and opportunity that change is desired. It may be time to get the wagons rolling.
September 2016: Mid-life crisis, or what to do when the tide turns.
It is not uncommon to come to a point in life where the certainties of the past no longer seem to work for us. It can be an unsettling and disorienting experience. Suddenly, for whatever set of reasons, perhaps a redundancy, divorce, bereavement, accident, sheer bad luck or surprising Brexit vote, we go from knowing who we are and how we like to live, work and relate to others to finding ourselves adrift and without our familiar bearings. The tide of our lives has changed.
It is important to recognise such a change. Naturally at first such change is unsettling and may make us feel deskilled. Where before you felt confident and familiar, now life has lost that comfortable rhythm and tempo. Where we had focus, and everything felt shipshape, now we seem to have a more scatter gun approach. We recognise we are using up energy without getting anywhere. If things continue like this we risk burning ourselves out.
However, if we can engage with this sense of change, recognise and learn more about the differences, then we may start to experience an unusual opportunity to reflect on who we are, what we have done so far, and what our relationships are like. With this information we may start to think about what happens next, and find our way into a more meaningful and renewed way of living, working, and relating to others.
For each of us this change will be a unique story. To call it a mid-life crisis is to throw a rather unhelpful, overused and generalised term over what is in fact a unique experience of change and development for each of us. But whatever we call it, it is better to work with the sense of change that we are picking up than ignore it. Tuning into the personal sense of change may take time, but as we work with it, like a sailor trimming his sails to a change in the wind, tide and weather, we find energy. So our sails start to fill again and provide the energy for the next phase of our lives. Tuning into the change in the conditions, and learning to use them to navigate and progress with, instead of ignoring them or fighting them is necessary work.
August 2016: Don't ignore the warning lights
Often people will describe living with difficult feelings. They might not have them all of the time, but they experience feelings that recur and that make their lives difficult. These might be feelings of anxiety, fear, stress, loneliness or anger. One solution is to try to ignore the feelings ‘ostrich style’, but another is to try to develop a different relationship with them. Clearly the feelings are difficult and it would be preferable not to have them. But, if you are someone for whom that is not an option, then you might benefit from finding out more about why you are having them.
A difficult feeling is suddenly set off that can’t be ignored and which makes your life uncomfortable. It is hard to make sense of the feeling and it gets in the way of having satisfying relationships and delivering your potential at work. It may bring on other lifestyle problems, interfere with sleep, lead you to drink too much, or develop other inappropriate ways of living. Ignoring it is probably not helping. But, it’s possible that these feelings might be thought of as a call to action. They are telling you that something is not working properly and needs attention, like a warning light on a car dashboard telling you to pull over now, something needs attention.
In my clinic I work with people to help them identify the routes of such feelings. To understand more about what triggers the feelings, and to help people develop more productive ways of living with them rather than the self-destructive habits that can develop through ignoring them.
19/7/16 : Good questions for psychotherapy
Often the reasons that drive us to seek psychotherapy are complicated. The problems that seem to repeatedly effect our lives and our relationships and our work are not simple. If it was simple we would have dealt with them long ago.
The challenge is how to find a way to get into the work of psychotherapy when our lives tend to follow patterns of us falling out of things like relationships or jobs? Once you have found a way into psychotherapy how do you stick with it and not repeat the well worn pattern of giving up on plans and withdrawing? Each time you withdraw you become more stuck in the experience of not finding a way out of them problem.
How do we find a way to pursue the questions that repeatedly bring us to this point and to stick with them? These are very good questions for psychotherapy.
May 2016 blog post: The remarkable power of a psychotherapeutic conversation
It is remarkable how a confidential psychotherapy or counselling conversation helps to open up questions and worries that someone may have kept to themselves for years. Sometimes, in just a few sessions you see someone open up about themselves in a way that they apparently have not done before, or not in a very long time.
As they talk about themselves and subjects they have hitherto worried about and kept concealed, they start to change. They may start to breathe more deeply and easily, they may become more relaxed in their chair. Headaches and worries that have been worrying them for ages, and which have sometimes lead to problematic medical diagnoses start to dissolve as conversation develops. They report that they are sleeping better, that bad dreams have stopped, that certain physical symptoms have lessened. They start to find a new perspective on themselves and their lives, and have a new energy for projects and ideas. And all of this happens because they took the opportunity to come for therapy or counselling. It is remarkable.
May 2016 Blog Post - Question: How do you judge when might be the right time to explore psychotherapy or counselling?
Answer: I think often you can have an idea that there is something going on, or that something is wrong, and have the sense that it requires attention. It can be easy and tempting to overlook this idea and sensation, but often the best course of action is to pursue the problem further through conversation. Ignoring it tends to kick it further down the road and leave it waiting for another time.
When we find the motivation and follow up on our sense that there is something wrong, or try to find out more about what it is that bothers us, rather than ignoring it, it often turns out be a route into areas of ourselves that have been ignored for years. The surprising thing is that often when we start to get to work on these worisome things we find a new energy and zest for life.
Question: But is this a good reason to see a psychotherapist or counsellor?
Answer: It seems to be the case that talking things through in complete confidence with an impartial psychotherapist helps us get to the bottom of what bothers us and helps powerful change to begin. It is often surprising just how much people find they are able to change because of this act of private conversation. It can help to change how we live, how we think about ourselves, how we take ourselves seriously, how we relate to other people.
Previous blog post: Getting beyond the persona - the protective front
In my work I sometimes find myself exploring the fronts that people have developed, the shells they have built around themselves, possibly from the very beginning, the sense they have learned and developed that for their own protection things must be kept secret. There may be many reasons why someone develops a protective front, they may have found that the worlds they were born into were not naturally protective enough, and that they have to adapt themselves and develop personas to keep parts of them hidden. It can feel like If they reveal the innermost workings of their minds there will be trouble, as a consequence, and sometimes from a very early age they learn to lock these parts of themselves away in a private room of the self.
It is possible to function fairly well in the world while keeping these more sensitive sides private. In doing so we find ways to protect the vulnerable bit of self, but we lose certain access to our creativity and spontaneity. it can look like we function as though nothing is amiss, but really we are not firing on all cylinders. It can become second nature for us to live like this and over time we can lose sight of the fact that part of us is missing, that we have locked this bit of us away. We can even forget that this has happened. Our lives continue, but in this rather underpowered way, we have lost sight of the fact that there is more to us that could be joining in. In time the effects of this way of living start to show themselves. We can start to become listless, irritable and lack focus, possibly depressed, and generally become a bit unwell.
Our relationships suffer because we are just not fully alive to the people we are with. It makes us less attractive. It makes it harder for us to know what we really want. Every so often we may catch a glimpse that there is more to us than we are able to connect with, we may have dreams that suggest this, we may find ourselves enjoying things that surprise us. We may find the sudden wish to tell someone 'this is not me! There is more to me than this!' There is more to us than we seem to know, but how do we find a way to open up and access, and bring more of our spontaneity and creativity into our lives and relationships?
Opening up these aspects of ourselves requires patience and care. We are trying to follow a delicate thread out of the labyrinth that we have built up around us. Originally we needed it for protection, for the secure retreat it gave us, now we want to emerge from it. Our stating point is that we know there is something missing, that life could be more fulfilling, that we could be giving more to relationships and career, that we could be demanding more from life. We know that there is more to us than the mask people see.
Previous blog post: Sanity, Madness and the Family revisited
I spent last Sunday at a seminar revisiting one of the Laing and Esterson cases, the Danzig’s, from : Sanity, Madness and the Family. It is always valuable to go over a case history. But, a question that I have always puzzled about this work is; to what extent did Laing and Esterson use their insights to bring clarity to the Danzig family?
To take an example, did Laing and Esterson share or interpret their observations upon the way the family deceived Sarah, with Sarah and her family? In Sanity, Madness and the Family (paperback p11, penultimate paragraph) it is reported that Sarah fears abandonment, and the parents and brother reassure her “...that they had telephoned everyday, and had left messages for her. This was not in fact so.” Again, there is a reference to the Danzig family not having called Sarah, and the subject of deception, in The Leaves of Spring, Esterson's full book devoted to the Danzig case, (paperback P261, para 2). It would appear that Laing and Esterson know that the family are not telling Sarah the truth when they tell her they have called everyday. But what did Laing and Esterson do with this information?
In the book, Laing and Esterson go to lengths to explain Sartre’s use of praxis (praxis refers to events that are the deeds of doers), and process (process refers to events of which no doer is the author). My sense is that identifying a point at which the family can be seen to be deceiving Sarah is a key piece of praxis, but I am left wondering why they would identify it and not explain it back to the family. Anyone who has been through a difficult family therapy knows how valuable it would be if someone could provide proof of behaviours rather than leaving the scapegoated ‘ill’ individual to live with the paradoxes and contradictions alone. To my reading Laing and Esterson seem to have had it within their grasp to provide such clarity; the family did not ring Sarah everyday as they said they did, so why did Laing and Esterson not make this known to the Danzigs?
16 Feb 2016 : Codependency, what is it? How to stop it?
Broadly speaking, in codependent relationships, one person’s help supports (enables) the other’s underachievement, irresponsibility, and immaturity while making the helper feel better about themselves.
Left unchecked, in codependent relationships, a pattern of relating develops in which one person becomes the helper rescuing the other from predicaments that they should learn to deal with themselves. Instead of seeing the predicament as an issue that they need to take responsibility for and thus develop more mature, independent and creative ways of functioning, the helper encourages the person to collapse and lean on them. In doing so the helper accepts and accommodates the person’s poor ways of behaving. This creates a downward spiral leading the person to create more problems that they then fail to manage and so rely on the helper even more. Instead of developing independence, they develop unhealthy codependence. The poorly functioning person exhibits distress, and the other rescues, and so enables them to continue in this vein. Over time this creates a pathological symbiosis where crisis and rescuing become experienced as shared experience, as love, in this way the codependent pair become bound to each other. It covers over the person’s incapacity to develop as a higher functioning adult while boosting the self-esteem of the helper who takes an increased sense of self from the experience. All of which reduces either parties’ interest and motivation for change.
This type of maladaptive and dysfunctional codependency is complex, and it will probably have a complex history which needs to be carefully acknowledged.
Something is needed to break this pattern of maladaptive functioning and relating. It may require each party to sit down independently with an impartial person who can help them gain a sense of perspective on what is going on in the relationship. Somehow the person has to find a way of breaking the pattern, of taking responsibility for their situation and instead of using it as a route into dependency, see it as a spur to action, to start to take responsibility for the problems they find themselves facing. This is a route into more mature functioning and ways of relating.
(6/12/15) Bereavement and the Mourning Process:
In the mourning process the mind works through all of the connections that made up the relationship. You go over a myriad of memories and associations of the lost person stitch by stitch. It is both conscious and an unconscious work, it is a complicated and emotionally draining process.
On the one hand you find yourself looking for memories of the lost person, on the other memories come to you unbidden. They may come to you in a dream, or in a memory provoked by hearing a song or eating a mince pie. The memories come from everywhere and anything. This is the process of mourning, of gradually coming to terms with what has been lost, the work of saying goodbye.
You are going over all of your attachments to the lost person as you reorder the memories and associations to your self. It is as though the lost person is coming home to you, settling into your mind and psyche. They are gone, but not forgotten, and this is the work of preserving them deep inside you. It is a natural process that takes time to work through, no one can really say how long, it is a process that requires its very own sense of time.
This is deeply personal work, but it may help to tell someone about it, or it may help to write to a shared friend and tell them about it.
4 December 2015: The dynamics of relationships endure. They don't stop just because you did or didn't say goodbye. But with death the possibility that you might one day meet and see that a former friend or loved one is ok is gone, and with suicide you know they weren't. You are left only with memories, silence and grief.
30 November 2015: working with anxiety
Sometimes problems come unforeseen and create tensions that if left unchecked become more complicated and create uncomfortable levels of anxiety. Something may go wrong in a relationship, or bad health might strike us or a loved one, something happens that we didn't necessarily see coming and we feel anxious about it.
For others it may be that we have never felt like we have been able to start our lives as we feel we would have liked to. Problems that are hard to get hold of have always seemed to be blocking our progress.
In either case we are faced with trying to find ways to start engaging with the issues and dilemmas we struggle with so as to find more creative and satisfying ways of living. It may be that in times like these a confidential conversation helps us to gain perspective and helps with the feelings of anxiety.
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