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Moving and Transitions
Contact me to talk about counselling; This is how it works.
Do I need counselling?
The drive for growth and mental health and wellness; Physis
Salve for the soul

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St Andrews Counselling & Psychotherapy Blog Opens
Working with Trauma:Early Deconfusion work
Transactional Analysis: The Ego State Model
View from the Bridge ( trigger warning contains reference to suicide)
More on Perfectionism: The Be Perfect Balloon

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My Blog

Moving and Transitions

It occurs to me that there are times in all our lives when we are moving on whether in our relationships, careers or making/ changing decisions. 
During this time of change we may make big or little steps in the transition as we change from one way of being to another.
Perhaps most of the time we don't consciously notice or even reflect on these important milestones in our lives. We may respond unconsciously to a feeling of restlessness or dissatisfaction or an urge to get away and so miss an opportunity to recognise a old familiar feeling or pattern in our lives.
I have had cause to think about these issues recently. I have felt comfortable and settled in how and when I work but have experienced feelings of stress and tension about continuing to work this way. I work with The Women's Rape and Sexual Abuse centre in Dundee which I have been since 2009, and started student counselling with the local university last year as well as in my own private practice.
An opportunity surfaced to look at renting an office space in St Andrews which got me thinking and when the office came up for sale I begin to consider that there may be more options open to me than I first thought.
Well, here I am now, with support from my family, to buy the office and focus my private practice,which has been fairly remote and rural, to being part of the town of St Andrews.
This has meant making important decisions about how I want to work now.
I have taking time to reflect, speak to peers, colleagues, family, friends and my close TA buddies. I could continue to keep everything going, to make sure all the plates keep spinning or I could do something very different, to make a move out of script.
So.... here goes....I have spoken to WRASAC and the University and given them notice of my moving on, which i do feel sad about.
I am going to work in my new office space in St Andrews as from late summer, early autumn, depending on the progress of the renovation work. I plan to be there 3 days a week, which will give me structure for my week and also increase access to therapy for local people. Here it is, the "before photo"!!
My new place is in a quiet residential area of St Andrews with a lovely park behind the building. The office has a main consulting room, a waiting area, toilet and a small kitchenette. The front window will be changed to be opaque and there will be a small discrete plaque on the door saying "St Andrews Counselling & Psychotherapy". There is on road parking.
What do you think about my new venture? Will you come and see me here?
Watch this space for the "after photo"!!!!

Contact me to talk about counselling; This is how it works.

Over the years I have found people contact me via various means to book a counselling appointment. Often there's a new email in my business inbox, as I have a separate account for counselling clients to make the initial contact. Sometimes the email is brief asking for an appointment or lengthy telling me all about what they are going through and how tough this is right now. Either way of getting in touch is OK with me.
I must admit I am excited when I see a new email, text or voicemail from a prospective client. I try and reply as soon as I can as I realise it's taken a great leap of faith to get in touch with me. I understand how much courage it has taken someone to summon up to pick up their phone and make the call. So an email or text makes this first step a little easier.
I do like to reply as quickly as I can by the same way of contact to thank clients and to set up a phone call.
I find client's like to hear my voice, they may have seen my photo and decided I look OK, and I find this first contact is really important for both of us for a number of reasons;
  • How do we both sound to each other?
  • Do we both feel we could work together?
  • Do we feel we both have an idea about what the problem might be?
  • Are we listening to one another?
  • Can you travel to where I work?
  • In answering your questions is there a rapport between us?
  • Is the business contract between us workable?
  • Do you have an idea about how long you are looking to work for, how flexible can you be around this or can you be open about how many sessions are affordable to you?
  • Can we agree on the date of the first appointment to meet and find out whether counselling is for you? 
  • I will need to ask you a few questions about how you see the problem, if you've had counselling before and why you are looking for counselling at this point in time. I might also ask you how you came across me such as a personal, family or friends referral or from my website etc.
Does this sound OK to you?

What questions might you want to ask me? Write them down before you call.

 I look forward to hearing from you.

Warm wishes, Carol

Do I need counselling?

Do I need counselling?

I guess if you are reading this blog then you might not be sure or you are pretty sure but not convinced. Something may have happened to you recently or in the past to start your search online to find someone who might be able to help you.
The incident or event keeps popping up in your thoughts and you can't seem to shake it off.
Or you may have had a relationship breakdown which has really hurt you.
Perhaps your relationships seem to end and you or your partner leave and you have started to notice a pattern. Maybe you always find a partner who is needy, demanding and betrays you or perhaps you tend to be unfaithful or look for excitement outside the relationship.
People decide to come to counselling for all sorts of reasons. They can have relationships problems with partners or with work colleagues, parents or their wider family. Often people find their way to counselling with a deep dissatisfaction with life or have always had a feeling of sadness or hopelessness which may have intensified recently.
"I really can't go on feeling this way for much longer" may have crossed your mind. You may have gone to see your Doctor concerned that you could be depressed as your sleep and appetite have changed and you aren't enjoying life or looking forward to the future.
Often those closest to you have noticed you have changed and tell you so, you may feel annoyed or defensive about being told this and deny you are not yourself.
A loss of some sort may have triggered your feelings of sadness, a bereavement or an upheaval in your life such as children leaving home, retirement, redundancy, chronic illness, divorce or separation.
Perhaps there's a deep feeling of being unfulfilled in life.
Let me help you. Contact me on 07824700980. Tell me what's happened to you and we can decide together if counselling can help you.

The drive for growth and mental health and wellness; Physis


“Je le pensay, & Dieu le guarit...We treat them but it is God who cures them.”

Physis
Introduction
This key piece of Bernian (1963) theory awakened an interest, and then reading Petruska Clarkson’s (1992) journal article on the subject. Within this article I will look at definitions and interpretations of physis theory; critique, compare and contrast this with other self-actualisation, realisation theories and key seminal work. To then explore how physis theory underpins Transactional Analysis (TA) principles. To look at what the implications of Physis might be for diversity, social and cultural beliefs. Finally, why is knowledge of physis theory vital in clinical practice? What are the benefits for the client and TA practitioner?

Defining Physis
Physis or Phusis, as it is sometimes spelt, is derived from the ancient Greek, meaning “to grow... to be...what things really are” (Edwards, 1967). Clarkson (1992) cites a more helpful meaning as “... change or growth which comes from the spirit within the person”.
Berne (1968) adds “the growth force of nature which makes organisms evolve into higher forms, embryos... into adults, sick people get better and healthy people strive to attain their ideals”. Summarising the literature; physis is a physical, emotional, spiritual, creative and evolving growth towards self actualisation and self realisation- being the best we can be. Implicit in this growth, change or evolution is the amount of energy the individual expends. Growth and change of any kind uses a high level of energy. If we put this into a TA context, pathology has its positive and negative sides, such as script, games, rackets, or life positions, to name a few. As for advantages, Berne (1968) puts it “...a neurosis has many advantages for the individual...  what is the force which makes him want to get better?”. What advantage is there for a person to get better if their neurosis serves them well? There must be a point for some individuals when a level of consciousness starts to recognise these thoughts, feelings and behaviours as unhelpful or along a continuum to harmful. 
This stance is diametrically opposed to the Freudian and psychoanalytical belief which emphasises the death and sex energies or drives (Mortido and Libido) and the Bernian/ Jungian belief in physis as Clarkson (1992) explains “... the drive toward health, wholeness and creative evolution.” Berne uses metaphor to personify the death and sex instincts as Thanatos and Eros respectively.  
Thanatos or Thanatus is the Greek god or daimon of non-violent death. His touch was gentle, likened to that of his twin brother Hypnos or sleep (Theoi 2010).

Eros was the Greek primordial deity of procreation who emerged self-formed and was equivalent to Thesis (Creation) and Physis (Nature)

The Greek goddess Physis is used as a metaphor for life energy as it manifests in nature, in growth and healing as well as in all dimensions of creativity. Physician or physic (as in medicine) and Physics (as in Quantum and Chaos understandings of the world) are both derived from it (Clarkson, 1992). 

 Thanatos and Eros would seem to be intrapersonal, or inside the individual, opposite to one another, instinctive and appear to be basic human drives. Whereas Physis, which does function at a basic instinctive level, has yet another dimension and incorporates the transpersonal and at a higher level of being. Physis is creative, transformational, evolving and aspirational (Clarkson, 1992).
Berne (1968) explains physis as being “...some force which drives people to grow progress and do better... religious people might say it was the soul... which normally pushes living things continually in the direction of progress”.  This life force energy fits well with the three guiding TA principles:
I’m OK- You’re OK 
Everyone can think 
Anyone can change

Steiner’s (1974) definition of script is clear and unequivocal:
“The script is based on a decision made by the Adult in the young person who... decides that a certain position, expectations, and life course are a reasonable solution to the existential predicament in which she finds herself ... between her own autonomous tendencies and the injunction received from her own family group. The most important influence... originates from the parental Child... the Child ego states of the parents... are the main determining factors in the formation of scripts”. 
The script paradigm is not wholly negative as English (1977) explains:
“We all need a script... an inborn need for structuring the time, space and relationships... conceptualise boundaries... to test... ongoing experience of reality... by constructing the outline of a script..., hold together... hopes, ...  fantasies, and...  experiences.”
Physis, the creative force of nature that makes things grow and strive for perfection, is the aspirational drive for autonomy, which arises deep in the individuals Somatic Child ego state. MacDonald (1972) defines aspiration thus:
“... to desire eagerly; to aim at or strive for high things”
 The script matrix comprises of five Counterinjunctions of “Be Perfect”, “Try Hard”, “Hurry Up”, “Please Me” and “Be Strong”, Petruska Clarkson (1992). The Counterinjunctions are from the individuals Parent ego state (Figure 4). Clarkson (1992) adds:
“... the values of being fast, energetic, pleasing, strong and excellent- as prized qualities of the autonomous individual under the influence of Physis... are differentiated from the counterscript drivers”.
 The second part of the script matrix is the Program messages from the parent’s Adult ego states and instruct the individual “How to”. The parental Child to the individual’s Child ego state messages are known as Injunctions, for example “Don’t Be” and Don’t Feel”, as well as the positive Permissions “Be Close”, “Think” and “Feel”. The individual’s script is not fixed or rigid as 
Cornell (1988) explains:
“Major script decisions can be made at any point in life. Times of crisis... will likely foster more rigid and therefore more dysfunctional elements in and individual’s script”.
 Therefore, a tension must exist between the aspirational drive (Aspiration Arrow), arising in the Child ego state, towards individual perfection, self actualisation and autonomy (Physis), and the constraining force of script to keep the status quo and the individual in possession of their neurotic thoughts, feelings and behaviour. Steiner (1987) illustrates this elegantly with the script-matrix diagram.
 
The Aspiration arrow may be seen as a metaphor for the flow of Physis energy within all individuals which runs as a golden thread or pure water spring through their ego states. The role of the practitioner must be to enable the individual to access their Physis, together, peeling away the layers of script and associated pathological thoughts, feelings and behaviour. This can then release the energy flow to course through the Child, Adult and Parent ego states and free the individual to reach their potential. Clarkson (1992) adds:
“… these creative urges- our needs to aspire toward fuller selfhood as persons and professionals”
Barrow (2008) utilizes metamorphosis, caterpillar to butterfly as a metaphor for Physis. Unique to those creatures who undergo metamorphosis are “imaginal cells”. These cells carry the genetic blueprint throughout the process. The complete and perfect butterfly emerges from the chrysalis. Barrow (2008) relates this process to Physis as follows:
“… I am interested in the idea of an imaginal cell working at a psychological level… that there is an inherent psychological mechanism that despite adversity maintains a vision for the individual of a new way of being... it captures the possibility for thriving- the essence of physis”.
Self-actualisation Models
In considering Physis as a psychological metaphor for the individual to reach autonomy does imply that other factors are significant, influential and be established prior to achieving this status. Maslow (1962) presented his “Hierarchy of Human Needs” which supports the premise that our physical or extrinsic needs must be satisfied before we can aspire to meet our emotional and intrinsic needs. Each element of the “Hierarchy” is dependant and builds upon the last and starts from the human being’s basic survival needs.
         
Maslow’s Hierarchy of Human Needs is a structured, hierarchical and sequential model, again, we can visualise this paradigm as a metaphor for human needs. The model, on first sight, does lack dynamism or drive; I have added the Aspiration Arrow to illustrate the energy Physis flows from the basic Biological and Physiological needs to Transcendence. The practitioner supports the individual towards autonomy and Self-actualisation (penultimate tier); the practitioner aspires to reach Transcendence, the final tier in the “Hierarchy of Human Needs”. 
In contrast, Educational TA practitioners have taken the familiar P-A-C ego state model and reversed this to C-A-P to articulate the Developmental TA (DTA) process and purpose (Barrow, 2003).

 Barrow (2003) expounds this theory further:
“Instead of existing under the implicit repression of the Parent ego state, the Child is regarded at the “growing edge”, the arena through which individuals… will reach further potential… underpinned by Adult reality checking and the security of healthy Parent beliefs and values… physis is explicitly identified and its line runs through all three ego states… realised by the Child through aspirations… framed through Adult thinking… supported by the security of the Parent”.
Criticism of this model is mainly around seeing the individual being relatively script free in achieving autonomy through aspiration. The author does describe the model as being “hopeful” as the individual would have a “winning script”, be motivated and able to articulate what they want to become. Nonetheless, there is a close connection with the three guiding principles of TA; I’m OK- You’re OK, Everyone Can Think, and Anyone Can Change (Barrow, 2003: Berne, 1968) encapsulated within the physis life force. 
Self-awareness and Growth
The concept of Physis appealed to me on a number of levels when I first heard it mentioned within the context of the script matrix diagram. I then looked at Clarkson’s article (Physis in TA, Vol.22, No. 4, Oct 1992) in the Transactional Analysis Journal (TAJ) and some of her associated writing on the subject. There’s seems to be a paucity of recently published work around what appears to be such a key factor in TA clinical practice. Although the term Physis is an ancient one going back thousands of years it is Berne (1968) who first named this concept for TA and Clarkson who developed the paradigm (Clarkson, 1992). Physis energy runs through nature and this includes the human life force.
Clarkson (1992) suggests:
“For people to change they first need to feel well and OK, that is, in touch with their life force”.
Hence, illness disrupts the individual accessing and experiencing their life force. It appears that the life force or Physis does not disappear or snuffed out; it is only death that extinguishes Physis. A metaphor may be likened to a candle barely alight, a tiny flickering flame, not enough to see or read with, in the room next door, but there nonetheless. The challenge for the individual is how they might, open the door to Physis and enable fresh air to rush in and rekindle the guttering candle flame.
Clarkson (1992) posits:
To kindle this is perhaps the most central and important of the therapist’s tasks”.
Clarkson and Fish (1988) add:
Some ego states from earlier periods in a person’s life may be fixated in response to early unmet needs or psychological trauma...the person will be unable to remain stable under stress and may revert to script”.
Diversity, Cultural and Social Factors
The concept of Physis, though not named as such, is a common thread throughout the major religions. Berne (1969) suggests:
“Religious people might say it was the soul”.
Clarkson (1992) adds:
“… striving towards connectedness with spiritual, religious or transcendental values. The core self can be conceptualised as the organising principle of Physis”.
 The major authors within TA texts do emphasise the importance of spirituality as a step towards autonomy.  
Kandathil and Kandathil (1997) describe individual autonomy:
“… when they make consistent efforts to be free in the sense that most of their actions-especially decisive ones- are self-determined and not socially programmed”.
In other words, freedom from the constraints and confines of script, this is a social form of programming. For the therapist the diversity, social and cultural beliefs of the individual must be discovered during early work in the assessment phase and be ongoing. These beliefs may be clear during initial work with the person, but as they move through therapy, issues around spirituality may come more to the fore as they access their power for self actualisation.
Physis and Clinical Practice
Application of Physis theory to clinical practice is a fundamental prerequisite if we are to believe Berne and Clarkson’s paradigm. They describe Physis and Physis theory as a driving force, aspiration to grow progress and do better. In TA terms, they warn against the deterministic constraints of script theory and empower the therapist and individual to aspire for change. Over-reliance on the script as hamartic, banal or losing in nature fails to understand the concept of transcendence (Clarkson, 1992). Cornell suggests:
“… a second parallel term-such as psychological life plan- to describe healthy functional aspects of meaning making in the ongoing psychological construction of reality”.
The therapist can assist the individual to re-experience Physis. Clarkson (1992) advises:
… in order to facilitate healing and self-realisation… they first need to feel well and OK, that is, in touch with their life force.”
In the application of Physis within the therapeutic relationship, the therapist first needs to have an awareness and understanding of the phenomena, and be prepared to share this with their client as a powerful tool for change.
Conclusion
Researching this piece of TA theory has been fulfilling yet challenging, although Berne wrote extensively on the topic almost five decades ago and Clarkson reprised his work 30 years ago, there’s very little current TA literature on Physis theory. This is surprising given Clarkson’s (1992) observation:
“… as a major concept in transactional analysis… it provides a drive-oriented theoretical base for Bernian belief and TA practice”.
The script matrix diagram with the added Aspiration arrow acknowledges that whereas script analysis is a key concept in TA and shows us where we are and where we have been, it is the striving for autonomy and self actualisation that drives us forward.
This article has brought into focus, for me, the three TA guiding principles and how Physis underpins this important piece of theory and the whole of TA clinical practice. 
Finally, Clarkson (1992) expounds:
“Without the experience of physis there is not the energy, the belief, or the capacity to even use help. Thus it may be both the first requirement in psychotherapy and the last”.

References
 
Agnew, L.R.C. (1963) Notes and Events: Pare’s Apophthegm. Journal of the History of Medicine, 18: pp 75-77.
Barrow, G. (2003) Introducing a Meta-Metaphor for Developmental TA. www.instdta.org.uk
Barrow, G. (2008) Learning Process, Physis and Imaginal Cells. www.instdta.org.uk
Berne, E. (1963) The structure and dynamics of organizations and groups. New York: Grove Press
Berne, E. (1968) A laymans guide to psychiatry and psychoanalysis (3rd Edition). New York: Simon and Schuster.
Berne, E. (1969) Games people play: The psychology of human relationships.Harmondsworth, Middlesex: Penguin.
Berne, E. (1972) What do you say after you say hello? The psychology of human destiny. New York: Bantam Books.
Clarkson, P. (1989) In praise of speed, experimentation, agreeableness, endurance and excellence. Institute of Transactional Analysis News, 25, pp6-11.
Clarkson, P. (1992) Physis in Transactional Analysis. Transactional Analysis Journal. Vol.22, No. 4, pp202-209.
Clarkson, P and Fish, S. (1988) Rechilding: Creating a new past in the present as a support for the future. Transactional Analysis Journal, Vol. 18, No. 1, pp 51-59.
Cornell, W. F. (1988) Life script theory: a critical review from a developmental perspective. Transactional Analysis Journal. Vol. 18, No. 4, pp 270-282.
Edwards, P. (1967) Encyclopedia of philosophy. New York: Macmillan
English, F. (1977) What shall I do tomorrow? In G. Barnes (Ed), Transactional analysis after Eric Berne (pp 287- 50). New York: Harper’s College Press.
Erskine, R. G. (1980) Script cure: Behavioral, Intrapsychic and physiological. Transactional Analysis Journal, Vol. 10, No. 2, pp 102- 106.
Kandathil, G. and Kandathil, C. (1997) Autonomy: Open door to spirituality. Transactional Analysis Journal, Vol. 27, No. 1, pp 24-29.
MacDonald, A.M. (1972) Chambers 20th century dictionary. Edinburgh: W. & R. Chambers.
Maslow, A. (1962) Towards a psychology of being. New York: D Van Norstrand.  
Steiner, C. M. (1987) The seven sources of power: An alternative to authority. Transactional Analysis Journal. Vol. 17, No 3, pp 152-167.
Steiner, C. M. (1974) Scripts people live: Transactional analysis of life scripts New York: Grove Press.
Theoi website (2010). http://www.theoi.com/Daimon.
Temple, S. (1999) Functional Fluency for educational transactional analysts, Transactional Analysis Journal, Vol. 29, No.3, pp 134-145.
University of Ottawa Canada (2010) www.isotope.uottawa.ca/.../physis/fhtml 


Salve for the soul

I was reflecting on my therapy work today and began to think about the client's I see week to week in my practice.
I probably see an equal number of men and women ranging from their early thirties to mid fifties. Most are very successful in their chosen careers and businesses. Some work in the public sector or have thriving full-time or part-time businesses they have built from the bottom up.
I have noticed that they have worked long hours and overcome adversity in becoming a success in their working lives.
Often they come to see me because despite their success and acquiring what they wanted they now find themselves alone, lonely, or struggling to find or maintain a close and loving relationship. They may have found what's  made them successfully in their working lives just doesn't seem to transfer into their personal lives.
They come to see me to find salve, a type of soothing ointment, for their souls. To begin to look at what they want from life, how to improve their relationship with themselves and to work through relationship difficulties with those close to them.
Often, I find, when the relationship they have with themselves improves and they understand and have self awareness of how they communicate, their personality and internal world, this positively impacts and improves their relationship with others.
Phone me today to book your appointment on 07824700980
Email carol.foote1@btopenworld.com

So Who am I and what am I like as a counsellor?

I know when people contact me by email, text or phone they will have a picture in their head of what I look like, how old I might be and be curious about my accent. Some will have looked at the website and seen my photo (which I do update and is not photo-shopped).
I wrote this blog to give you another dimension to me as a counsellor and to let you know what my clients and colleagues say about me.
Clients say I am a warm and friendly person who they feel a connection with quickly and also feel safe with, and that I can be trusted. Others have said that they like my sense of humour and ability to laugh with them. I have been told that I am a very good listener and that they feel able to tell me things that they haven't told another human being. I feel truly honoured to be entrusted with their worries, concerns, thoughts and feelings about their lives. Clients have also said that I am respectful of them and take my time to allow them to tell me about their lives and the difficulties they face. Often clients will tell me that they feel better after a session and that something has been soothed in them, or that they understand themselves a little more and experience compassion for their situation and for what's happened to them.
Colleagues say they experience me as wise, empathic and having a maternal or motherly energy about me. They enjoy my fun sense of humour and how much I love to laugh with them. My colleagues also refer people to me for counselling and psychotherapy. They describe me as intelligent, warm and supportive.
I love my work. I get to meet people, get to know them, work together with them and support them to feel better and move on with their lives.
Is there anything you would like to know about me as a counsellor?

View from the Bridge ( trigger warning contains reference to suicide)


An Alternative View from the Bridge
Last Thursday morning I was driving over the Tay Road Bridge on my way to work with the Women’s Rape and Sexual Abuse Centre in Dundee. Half way across I noticed a red shape on the outside rail and squinted to see what I thought might be a new road sign.
As I drove closer the shape became clearer, the shape became a woman, a young woman sat astride the outside rail looking over the edge into the water below. She was hunched over holding the rail. At that moment I knew why she was there, her presence out of context with the monotony of the grey bridge. She was dressed in red with short bright blonde and purple hair, not a road sign, but the signs of her intention was clear.
I stopped, but realised quickly that I had already travelled past her, I put my hazard warning lights on whilst traffic continued to thunder past me. The cars and lorries seemed not to have seen her at all, they didn’t even slow. I couldn’t drive on, I couldn’t leave her in the balance between life and death. I was scared. I phoned 999, they told me they had received a lot of calls, where was she on the bridge, I replied half-way, she was half-way over the bridge and half-way over the rail and half-way between life and death. She had been seen.
I had to get out of the car, no one slowed behind me, the lorries swept past, and the bridge vibrated beneath my feet, then a white car stopped behind me, she was on the phone, I got out of my car carefully, watching the traffic, this was dangerous for me, I had stopped to help and scared I was going to get run over. I moved back past the white car and towards the girl on the rail, the white car gave me a feeling of protection and shelter from the speeding traffic.
I stood below and near to her, she lifted her head, I told her my name and asked her for her name “Doesn’t matter what my name is as I am going to die”, she looked over the rail into the water. The wind was blowing and I felt the chill, I too looked into the water which swirled and eddied beneath the bridge. I felt sure if she allowed herself to fall, she would disappear into and under the water. I didn’t know how long she’d been there; she hadn’t jumped or fallen so there was hope. I knew this meant she was feeling ambivalent about falling off and ambivalent about dying, she was holding the rail tightly and she was astride but there was a look on her face as she seemed to be considering letting go. She had one leg on the bridge side, the living side and one leg on the outside, the dying side.
I didn’t stand very close, touch her or try to pull her in, I needed to keep myself safe. I began to talk with her, I told her my name and how I had seen her. I wanted to know her name, Anna, what had happened to her? She was an inpatient waiting to have ECT which she was sure wouldn’t work, nothing was working, she was a burden to her family and friends, things would be better for everyone if she was dead.
I was beginning to recollect the ASIST suicide training I had done 3 or 4 years ago and Tony Whites work on suicidal ambivalence, to make contact with the “death side” of the psyche before the “life side”, to understand and hear what’s happened to bring her to this point. I said to her that she must be in unbearable pain to want to die, she agreed, she had been thinking that dying was the best thing to do, she couldn’t stand feeling this way anymore, she had suffered with depression and nothing had helped or worked (medication, psychiatric help, hospital, mental health care) and no one really cared about her anyway. I told her I felt very sad hearing how much she had been through, how hard life had been for her and that she wanted to die.
At this point the Police arrived, the traffic on the bridge stopped and there was an eerie silence while the cold wind whipped around us. A police officer approached and introduced herself and I told her about what had happened to Anna. Anna began to look more and more into the water, at one point she moved her inside leg up the rail, signalling her intention to fall. We asked her about who she loved, her partner and her cat (no one else did, especially not her family or mother), and began to talk about them, that they cared for her and how sad they would be if she died. I told her that I cared, she began to cry, I cared enough about her to stop and come and talk with her, the police officer concurred. Anna began to make eye contact with us and then look again down into the water. She then said “You’re going to arrest me if I come down, aren’t you?” to the police officer who replied “No Anna,  I am not going to arrest you, you are clearly in crisis and when you come down I am going to take you back to the hospital and tell them about what’s happened”. I said to Anna that I had coffee in my car and hoped she liked cappuccino, the coffee was for her. 
Anna looked at us in turn and briefly into the water and began to move her outside leg slowly, she was very cold and this took effort, we didn’t touch her until she was over the rail and safe, she began to cry and we touched her then. I went to my car and brought her my coffee. I had promised her this, she took the coffee and sipped it slowly, I told her how glad I was that she was safe, I touched her shoulder and her cheek to make contact and to show her that I cared. The police officers either side of her held her arms gently and led her to the police car. I walked back to my car along the silent empty bridge, got in and turned the hazard lights off, I felt so cold, I put the heating on full and continued my journey to work. As I left the bridge and joined the busy traffic in Dundee it was as if what had happened felt as if a dream, I had woken up from an eerie interlude and carried on my day, no one around me had known what had happened gave this a feeling of unreality.
Once I arrived at WRASAC I told my fellow therapists what had happened and had a de-brief of the whole incident, they were wonderfully supportive and offered me positive unconditional strokes. I was so happy to be with them and felt safe and cared for throughout the day. My family were very supportive, although my husband expressed his anxiety about having put myself in danger, I had told him about what I had done to risk assess the situation and acknowledged to him and myself that this was risky and how glad I had been to see the police.
I attended clinical supervision 2 days later and recounted the incident there in the safe and supportive environment of my peers and supervisor who gave me more positive unconditional strokes, I felt very cared for and well stroked! I feel fortunate to have such wonderful support.
On reflection I know that I couldn’t have driven past her, I felt a connection with Anna, as a fellow human and had some understanding of her distress. I also felt that if this had been a friend or member of my family about to harm themselves, I would want someone to stop and offer a caring presence, even if they hadn’t been trained or know what to do.
If you are reading this, I would encourage you to consider taking an ASIST course, or First Aid Mental Health course in the same way that you may have done basic Life Support or Resuscitation training. So many people’s lives have been saved by passers-by acting quickly to resuscitate after an accident or heart attack. What’s so different in being trained in offering someone a lifeline when they are in distress? Of course I know not everyone can or will be saved whether it’s from a physical or mental injury and not everyone feels they have the skills to stop and help and that’s OK. All I ask is that you take a few moments to think about it. (Carol Remfrey Foote: May 2016)
  

New Year Resolutions why do they fail?

We have all resolved on the 1st of January to change some aspect of our behaviour that we want maybe to stop smoking, lose weight etc etc.
Gyms see an exponential increase in membership as people resolve to lose weight and get fitter after an indulgent calorie rich Christmas. The gyms are crowded for 3 or 4 weeks and we continue to pay membership fees long after we stop going because our priorities change and we find less energetic ways to pass time.
So we know why we do it, the new year is a fresh start, turning over a new leaf. So why doesnt this resolution last? Why dont resolutions last?
If we look at the ego states involved the impulse to change or stop is likely to originate in the Parent ego state which tells you " You are too fat" "Stop smoking or you will die', "You drink too much' any of this sound familiar?
The Child ego state resents the deprivation of food, drink and relaxation and undermines the Parent decision or contract to change and ones determination begins to wobble. "I,ll miss today at the gym because..... or I can have one cigarette or drink it wont hurt, I can stop anytime I want to."
The energetic dialogue takes place between the Parent and Child without the Adult ego state involvement. The Adult here and now rational ego state problem solving part of us can look at how we might sabotage ourselves and involve the Parent and Child in self care decisions. The Adult  can look rationally  at our drive to lose weight " How much weight do we need to lose,  what is the realistic target?" and look at information such as a 2 lb weight loss per week is less depriving of the Child, whilst satisfying the Parent ego state. Getting all the ego states on board is likely to succeed. Rewarding and giving ourselves strokes for how we are doing keeps motivation going.
So consider a New Year resolution as a statement of intent and then plan how to make the change you want, think about how you might sabotage your plan, be kind to yourself and accept when you take a step backwards that you are ok and this doesnt mean you have failed. 
I hope 2015 brings you health, happiness and contentment.

Today is National Depression Screening Day

Today is National Depression Screening Day in the USA. What a great idea!

To my knowledge, I don't think we have this event in the UK, but maybe you know if we do? What about my regular blog readers, do they have this day in your country?

Depression is a common mental health issue and no doubt you may have suffered with this illness or know someone close to you who has had or has depression?

The American Psychiatric Association (APA) has an excellent website and a link to test yourself to see if you might have depression...try it if you think you do. Copy and Paste this into your browser.



The website test is very quick and can also check for Generalised Anxiety Disorder, Bipolar, PTSD, Alcohol Misuse and Adolescent Depression.

At the end of the screening the site can put you in touch with useful resources and advice on what to do next.

If you do have a score which indicates that you may have a mental illness then do seek help from a medical practitioner (GP) or contact a counsellor or therapist who is trained to help you.








More on Perfectionism: The Be Perfect Balloon

Perfectionism is a hard task master, so where does this personality trait come from?

Why do some have this trait and others don't?
What can I do about my perfectionism?

As with all personality traits there is a dark and bright side perfectionists well know.

We develop perfectionism early in life, the Be Perfect Driver is one of a few others. Be Strong, Hurry Up, Please Others and Try Hard (Kahler, 1975) are the other 4 drivers.
The 5 Drivers may be described as antidotes to injunctions, or decisions we make in childhood. This illustration (below) shows how the drivers, as balloons, hold us above the water, whilst the injunctions (shown as weights tied to our legs) pull us down.

The "Be Perfect" Driver Characteristics
Imperative
  • I must be perfect, wonderful, correct in every way.
  • I must succeed in everything I do.
  • I must get top marks and win.

Identification
  • Exact language, including qualification when they are not sure, such as 'probably', and absolutes when they are, such as 'absolutely'.
  • Always neat and well-groomed.
  • Never completely satisfied with what they do.

Benefits
  • Hard-working, with excellent quality output. Attention to detail. High standards.
  • May achieve great things.

Problems
  • Fears of failure and losing control, and subsequent over-compensation.
  • Over-work. Not finishing things for fear of criticism. Prevarication
  • Expecting others to be perfect too.

Treatment
  • Laughter.
  • Praise, including for less-than-perfect work.
  • Reframing of what 'perfect' really means to 'good enough'.
  • Be very specific with criticism (and praise).
Recognize these drivers in yourself and others and treat them accordingly.
See also
 
Kahler, T. (1975). Drivers—The Key to the Process Script.  Transactional Analysis Journal,5:3
 



























Kahler, T. (1975) Drivers-The Key to the Process Script.  Transactional Analysis Journal,5:3
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