Have I got SAD – or do I need to slow down?

Lucy Hyde on 13 October 2023

Carved stone face in a wall with hills behind

What is Seasonal Affective Disorder – and do you have it?

How do you feel when the days start getting shorter? Do you experience a building dread of dark mornings, where you struggle to drag yourself out of bed? Do you look forward to being able to coorie in under a blanket when it’s gloomy outside? Or perhaps it’s not the lack of light that you find difficult, but the weather – not being able to soak up the sun like a solar panel prompts anxiety that your battery is going to run low.

Seasonal Affective Disorder – what does it mean?

SAD (Seasonal Affective Disorder) is a term used for feeling depressed, low in motivation and lacking in energy at certain times of the year. ‘Winter-pattern SAD’ is when people begin to experience symptoms in autumn and through winter, but some people also experience mood changes (anxiety, agitation) in spring and summer – ‘summer-pattern SAD’ – although this is less common.

The jury is still out on what exactly causes SAD – there are a number of factors indicated, including melatonin levels and vitamin D. People with a family history of depression are more likely to experience it. For some people, these changes in mood can be really debilitating, meaning that they experience severe symptoms of depression for almost half the year, so it can have a huge impact on their enjoyment of life.

Trees at the edge of water with mountains behind

Being human in the world

I’m absolutely not denying the reality of people’s experiences, or to suggest that you shouldn’t seek support for managing symptoms of depression, fatigue and social avoidance or anxiety. But for most of us, when we notice some changes in how we feel at different times of year, I wonder how helpful it really is to casually adopt a ‘disorder’ label.

I also wonder how much SAD is a product of a modern society that has evolved to a point where we need to ignore our bodies’ natural tendencies, in order to see ourselves as ‘operating productively’. The period where industrial and post-industrial society developed is the blink of an eye when compared to the timescale over which human animals evolve, and perhaps our bodies are struggling to catch up with the expectations of capitalism. Doing more than we have energy or capacity for (whatever the reason) ultimately leads to burnout and exhaustion – often manifesting as depression or anxiety.

The urge to see ourselves as somehow ‘other’ from the natural world has contributed to an inability to truly acknowledge the destructive impact humans have had on the world as a whole. Life as humans have come to live it in the 20th and 21st centuries has encouraged us to suppress our natural responses to the changes in the world around us – including regular, seasonal changes – to the extent that when we notice that we’re feeling differently, we try and make it ‘wrong’.

‘Disorder’ or natural response?

Following this line of thought, I wonder if there is a healthier, more compassionate approach to changes in mood and energy levels related to the shift into autumn and winter. Rather than asking ourselves ‘how can I feel more like I do in the summer?’ perhaps we can ask instead:

How can I be more understanding of my changes in mood or energy?
Where can I look for opportunities to live in the way that my whole self needs?
What do I need in order to take care of myself so that I can be ‘well enough’ in the world as it currently is?

Let’s explore these questions a little bit more.

rowing boat at the edge of sea with mountains behind

Bringing a compassionate understanding to our responses to seasonal change

The phrase ‘the natural world’ tends to be used to denote something separate from humans, and all human-created things. But human beings are animals, and it doesn’t serve us well to think that we don’t have the same basic needs as other mammals – eating, resting, mating, etc. We are still part of an ecosystem, although we collectively tend to try and distance ourselves from the rest of the world in an attempt to avoid the pain of acknowledging our destructive behaviours towards it.

In the Global North, until only a few hundred years ago, humans lived in a way that was much more responsive to the seasons. Our survival depended on us having a closer relationship with the land that fed us. Of necessity we needed to be much more active at certain times of year to produce, gather and store the food that would keep us going through the months of scarcity. While humans didn’t hibernate like some creatures (that are able to slow their body rates down in winter), the pace of life would have been slower over darker, winter months, where there was less to do on the land. Depending on food stores, there might be less food to provide energy for activity. I have a friend who works in a physical, seasonal job, who refers to the depths of winter as ‘plumping-up season’.

I also wonder how much we allow ourselves to live with the fluctuating energy levels that develop as part of the ageing process. Our bodies evolved to fulfil different roles at different life stages, and historically women wouldn’t expect to live for decades after our ability to procreate ceased. I’ve noticed that post-menopause, I tend to naturally want to be less active in the winter months. It’s difficult to know how much of this is connected to the changes in my body and energy levels, and how much is because I have learned to better tune into my body’s needs rather than overruling them.

Would you describe yourself with the words ‘I like to keep busy’? If so – have you ever thought about what that ‘liking’ is about? Many of us use busyness or activity as a coping mechanism – it distracts us and helps us avoid feelings. If we’re not being active we may start to feel anxious, and attach this anxiety to a ‘problem’ that we can then get busy trying to fix. If this rings true for you, then any natural slowing-down tendencies you may experience during winter months might feel a bit scary, because allowing yourself more space brings the potential for anxiety.

Living in the way that our bodies need

I’m fortunate to have moved myself to a career that allows me some freedom to dictate my working pattern through self-employment. In recent years I’ve come to realise that I have less energy towards the end of the year. I need to bear in mind, when planning ahead, that setting myself goals for the last quarter is unhelpful – I don’t achieve them and I end up feeling I’ve failed or ‘not tried hard enough’. I can structure my appointments so that most days I can squeeze in a quick dip in the sea, which particularly works for me in the winter as it gives me an intense burst of ‘outsideness’ when I may not feel motivated to go for a long walk.

Not everyone can dictate their working pattern or life to this extent; even if you recognise that your body would prefer you to have a different structure to your day, this may not be possible due to the requirements of your job or employer. However, most people have at least some autonomy to tweak aspects of day to day life – if they can allow themselves to recognise the value of prioritising their needs.

Ask yourself whether you really want to be more active or energetic in winter. Is that about your needs, or does it have the words ‘I should’ attached to it? Is it influenced by what you imagine others think or do; have you been affected by what you perceive as societal norms, or the ‘living my best life’ impact of social media? Most of us are influenced by these factors to some extent, even if we like to tell ourselves ‘I don’t care what others think’.

Modern society as lived in many countries is focused on productivity to a degree that is unhealthy for the planet and for us, creating a myth that economic growth is desirable and feeding fears of scarcity. It benefits the world when we do less, as well as allowing us to recover – and to save money. If you feel the urge to shop to ‘cheer yourself up’, try pausing for a moment and checking in with your inner self what need you might be trying to meet. How you might turn towards that part of you with kindness rather than trying to distract yourself from it by looking for external stimulation.

Taking care of ourselves ‘well enough’

We’re living, breathing creatures and how we feel changes depending on what’s going on around us, and the events and stresses that we’re subject to in our lives. That includes weather, daylight hours, temperature. Telling ourselves that we can carry on operating at the same capacity whatever happens around us, and to us, is a denial of reality and longer term isn’t good for us.

However, in order to carrying on living in society it’s necessary to accept that the modern world isn’t currently responsive to the needs of most of the world’s inhabitants (of all species). My ‘perfect world’ might not be the one I currently live in, and it’s important to recognise that, and allow myself to feel the grief of it, but I also have to find a balance that is ‘good enough’ for me to keep living in the world as it is.

I think of this as a little bit like the experience of being autistic in a world where the neurotypical experience is privileged. Autistic people shouldn’t have to do all the work to adapt to a society that often doesn’t work for them, but until society itself evolves to be more accessible and accepting to all, the choice for autistic people can sometimes be (unfairly) adapt or withdraw.

What might help develop self-compassion?

I use a Focusing practice to regularly check in to what I need. Although having a routine helps me, it can sometimes mean that I shut myself off from noticing when I need to slow down. I (try to) accept that I might not always know what I need, and that this will change from day to day – and perhaps more importantly, I give myself a break if I realise I’ve overdone it or made the ‘wrong’ choice. Learning to listen to what your whole self needs – rather than to the internal parent or inner critic that’s very good at telling you what you ‘should’ be doing – can be truly healing.

Treatments that are recommended for SAD are worth considering, but pay attention to what feels right for you, rather than trying to convince your body that it’s not really winter. For example, generally I’m an early riser and structure my work to suit this. For a few months of the year, though, my body would really like to wake later but it’s not practical for me to chop and change appointments. I use an alarm-clock-light that gets gradually brighter to simulate sunrise, which helps, but I also accept that I feel more sluggish in these few months of dark mornings, so I have lower expectations of what I’ll achieve.

But what if SAD really fits my experience?

If you experience severe depression as a result of changing seasons, you’ll probably find it helpful to investigate this with the help of a counsellor or psychotherapist. People severely affected by SAD are more likely to have depression, bipolar or SAD in their family history. This is as likely to indicate inherited emotional dysregulation (patterns of thinking, feeling and behaviour are often passed down through families) as a ‘genetic tendency’. There’s a good chance that, with the support of an empathic other, you can make changes that will help you feel better (and perhaps interrupt the generational cycle too).

While it’s increasingly accepted that there’s no evidence for the ‘chemical imbalance in the brain’ theory of depression, antidepressants can still be helpful for dialling down strong emotions to a point where you can begin to tackle the issues underlying them. There are other self-help suggestions for SAD here .

I don’t believe it’s helpful to assume that changing moods or energy levels are a ‘disorder’. Arguably it could be disordered thinking to believe that we should continue to function in the same way all year round, unless we live in a part of the world that doesn’t have significant seasonal changes.

Even a happy life cannot be without a measure of darkness, and the word happy would lose its meaning if were not balanced by sadness.
Carl Jung

If you find it difficult to tune into what your body is telling you that you need, or if you find it scary or uncomfortable to sit with strong emotions, you may find it helpful to learn Inner Relationship Focusing, which is a self-help practice that supports development of a compassionate attitude towards parts of yourself that you usually ignore. Please get in touch if you’d like to learn more about it, or watch the video on this page.

cloud in valley below mountain and blue sky

Further resources

Does counselling REALLY change lives?

Lucy Hyde on 23 February 2023

‘Counselling changes lives’ is the strapline of the BACP (British Association for Counselling & Psychotherapy ).

I realised recently that it’s 20 years since I had my first experience of counselling, as a client. It prompted me to think about the course that my life has taken since then, and to see that counselling did change my life.

I can’t remember now, exactly what it was that prompted me to seek counselling in 2003. I was miserable, I know that much. Feeling depressed, stressed, trapped, that life was meaningless, not feeling good enough – all these had been familiar states of being for me as long as I could remember, certainly since early teenage. I didn’t think of myself as having a bad life, as these feelings were interspersed with periods of relief, moments of joy, happy events and the comfort of some truly meaningful relationships.

I think I was probably closer to truly believing “I can’t cope” than usual. “I can’t cope” is a phrase that I’ve become accustomed to hearing from other people, yet actually unhappy people are very good at coping. Coping is what we do; we manage, we survive, we keep on going. Often, I believe, when we say “I can’t cope” to another person, something in us is saying “I don’t want ‘coping’ to be my way of life. I want more from life than ‘coping.’”

I remember that I went to my GP. It wasn’t the first time that I had spoken to a doctor about mental distress, although I didn’t have the language to describe it other than to say that I was stressed. Although the word ‘depression’ had resonated with me for many years I thought that people who were depressed didn’t have functioning lives so didn’t think I had the right to the word. On at least one previous doctor’s appointment, I’d been offered medication, but had been reluctant to pursue that route, thinking agreeing would be an admission that I was never going to feel better (rather than seeing it as an opportunity to help me feel better).

I can’t now remember whether I was offered anti-depressants in 2003, but I do remember the GP giving me a leaflet with a list of local counsellors and counselling organisations on it. They couldn’t provide me with this via the NHS, but they could signpost me to where I could access it for myself.

I now see that even that was hugely important – the doctor (I can’t remember who it was, but I can certainly remember those old white male GPs who it sure as shit wouldn’t have been) helping me believe that talking to someone was a valid avenue to pursue, and also that there was something I could do for myself that might help, rather than getting that via the NHS. GPs even now have a powerful role, and that GP – though I had wanted them to tell me what to do – handed some of that power back to me.

Clearly I was in a sufficiently privileged position to be able to pay for counselling, although I’m sure I, like many clients I’ve worked with since, struggled to believe that it was really a justifiable expenditure. I expect I could probably have afforded more than the 4 or 5 sessions I permitted myself, but at the time, my emotional wellbeing didn’t sit in the same position in my priorities that it does now. In fact, the phrase ‘my emotional wellbeing’ wouldn’t even have been in my vocabulary.

There’s lots I can’t remember. I can’t remember the name of the counsellor who I saw, although I’m reminded of them anytime I pass the end of the street that they lived on, where I would visit for sessions on dark winter evenings. I wouldn’t recognise them if I passed them in the street. I don’t remember much of what we talked about.

What I do remember is that, during those few weeks, I noticed an advert in my local paper for care assistants at a local respite centre. The pay was significantly lower than my earnings in my customer service role in a financial company, yet something drew me to it. I didn’t really believe I should apply for a job as a care assistant; I worried I was just trying to run away from work stress in my existing role, but I mentioned it to my counsellor, who responded as if it was a perfectly normal thing to be interested in, and helped me explore the potential rewards and fulfilment in such a position that were missing from my job. I remember her suggesting that caring for others might in itself be something that I would find nourishing.

It was possibly the first time that I’d been encouraged to trust my gut instinct for what felt right, rather than what I imagined was the appropriate or culturally expected way forward (and by culturally I mean my family culture as well as society; I already thought I was a failure for not having a ‘graduate’ job).

I went into the session wondering if my counsellor would know what was wrong with me for being attracted to that job. I came out of the session thinking “I am allowed to want this.”

And I made a change.

I resigned my job in the city and exchanged a long bus commute for a half-hour drive across farmland in the opposite direction, to Leuchie House , a respite centre for people with long-term conditions. I can remember those first shifts, where I didn’t really know what I was doing, but was blown away by all the interesting guests (we never called them patients) I got to meet, and nourished by the gratitude and appreciation they expressed to me for helping them with tasks of daily living that I took for granted.

It changed my life.

I didn’t stay in the role for long. Caring wasn’t for me after all, plus the pay levels at the time were unsustainable for me, on top of running a car to commute 30 miles a day (there being no public transport). I found the process of deciding what to next, 10 months later, stressful, and felt anxious about my future all over again – but I still didn’t regret having made that move. I remained with the organisation, ultimately moving to a managerial role and developing a career in human resources, and stayed there for 13 years, during which the organisation went through some incredibly challenging times, and so did I.

It wasn’t perfect, and at times I struggled with work stress. By the time I left to build a private counselling practice, I felt I had given as much as I could and was ready to go.

But I also thrived in the various roles that I had, and at times felt a sense of purpose that had been missing, being part of a team working towards a single aim, that of providing the best possible nursing care in a holiday home environment. I met and worked with some really inspirational and passionate people. And the experience that I gained, including practising mediation skills, having difficult conversations, supporting colleagues through difficult times, meant, when I was offered the opportunity to do a counselling skills course, I jumped at it, which ultimately led me to being a therapist today.

I’m absolutely not saying that I took one step in a different direction and never looked back. The decision to switch jobs didn’t change me totally. That younger Lucy, who was stressed, depressed, anxious and self-judgmental still resides within me. Although she doesn’t appear anything like as much, or have such an influence on what I think and feel and do, that’s not just about me having had one change of direction. It’s thanks to many years of therapy, lots of hours of psychotherapy training, learning Focusing skills and practising behaviours or skills to shift my mindset, over those 20 years. Plus a bunch of other experiences, influential people and being taught to see that difficult times could also be AFLOGs (Another Fucking Learning Opportunity for Growth).

But, as I look back over 20 years, I can see the thread that links my life now – as a therapist moving into my seventh year of self-employment – to the choice I made as a result of those few counselling sessions in someone’s living room 20 years ago. I can see the thread that links some rewarding adventures, following scary decisions, to the encouragement, from that therapist back then, to trust what feels right, not what I imagine other people think is right.

And I’m very, very grateful to that anonymous counsellor whose name I’ve forgotten, and who doesn’t know the huge difference she made. Counselling changes lives.

If you’ve read this you might be wondering whether you could use some help in making a big decision – or a small one. A decision that might seem relatively small, can have a much bigger impact on your life than you expect.

Or perhaps something is feeling off-kilter in your life and you don’t know what to do about it. Maybe you don’t want ‘coping’ to be your life. Talking to someone can help you to access a deeper understanding in yourself, and discover that there is wisdom there that can show you the way.

You might find it helpful to read about how therapy works – what the process is like and how counselling promotes change.

If any of this resonates with you – please get in touch, even if it’s just for a chat to see if counselling could help change your life.

What happens in therapy? – PART 1

Lucy Hyde on 16 March 2022

The practicalities of counselling

I decided to write this blog for anyone who’s wanting to get an idea of what to expect if they start counselling.

The questions ‘What happens in counselling?’ or ‘How does therapy work?’ can be answered in different ways so I’ve split this blog into 2 parts.

Part 1 looks at the practicalities of starting therapy, and what happens at a conscious level, including the sorts of questions I might ask, setting goals, boundaries, and the control you, as client, have over the direction we go in.
Part 2 speaks more of what it is that makes talking therapy a useful contribution to helping people to ‘feel better’, touching on the neurology behind psychological healing – the unconscious stuff that’s going on while – and after – therapist and client talk.

I’m writing from my own perspective – i.e. about what’s likely to happen if you and I work together. While much of what I say will hold true for many other psychotherapists and counsellors, there will be variations in the way we work.

lucy hyde online therapy (image eileen-pan-unsplash) — *Image: Eileen Pan on Unsplash*

What happens in therapy – Part 1: The Practicalities

So………you’re thinking you might find it helpful to see a counsellor. Or someone’s suggested to you that it might help. Or perhaps they’ve told you that ‘being in therapy’ has helped them. What happens when you take the next step, and get in touch?

Initial contact with the therapist

When you contact me, sometimes I won’t have space to start working with you straight away. If so, I’ll ask if you want to go on my waiting list, and I’ll usually suggest some colleagues who may have availability.

Sometimes by the time I get in touch to offer someone on my waiting list a space, they’ve found someone else, which is absolutely fine and to be expected. At this stage, I don’t usually ask you for information other than contact details, until I know we’re going to start working together.

That’s not because I’m not interested in you – it’s because a) I don’t want to hold unnecessary personal information about you unless we actually start a relationship, and b) your situation may have changed by the time I have a place, so the information I gathered is out of date anyway.

Even a brief email exchange agreeing the above should give you a bit of a feel for what I’m like, and at least a hunch as to whether you want to work with me. Forming a working relationship is really important in therapy (more on that in Part 2). If, for some reason, I get on your nerves, it doesn’t have to mean we can’t work together – but no matter how good the counsellor is, sometimes there’ll be personality clashes.

Trust your instincts UNLESS you reach the point where you simply think you will never find the ‘right’ therapist – it may be that something in you doesn’t want to! In which case, try someone – or a few people – who feel ‘good enough’, to get started.

We’ve agreed to start working together – what now?

The dreaded paperwork! I ask people to complete a brief assessment form to check I’ve the experience and skills required, and – if we’re going to be working online – that I believe online therapy is appropriate.

Lucy Hyde online counselling (image shayna-douglas-unsplash) — *Image: Shayna Douglas on Unsplash*

I usually offer a chat over the phone at this stage – sometimes that’s the easiest way for us to compare diaries and find a time that works for both of us, and I can take some assessment notes at the same time, which some people prefer to the form-filling.

We’ll also talk about HOW we’re going to work together. At the time of writing this blog (early 2022), I’m offering:

online counselling via Zoom video call, instant messaging and email;
tele-therapy / phone counselling;
walk-and-talk therapy – counselling while walking outside.

If you’ve decided you want to work in-person with somebody in a room (the ‘traditional’ way of counselling) I can signpost you to other people who may be able to offer you this.

Again, this is an opportunity for you to get a sense of what it might be like to have sessions with me. If we decide to go ahead and book a first session, I’ll send you an agreement or contract to read over, complete and sign. The agreement goes over practicalities like fees, privacy and where/how to complain if you’re not happy. There’s no requirement to commit to a certain number of sessions.

What happens in our first counselling session?

There are a few areas I usually cover at the start of the first therapy session (e.g. confidentiality, cancellation policy), which are also in the written agreement – I go over them again because I think they’re important. At the end of the session I’ll check with you how the experience has been, and whether you want to continue; we’ll confirm further details, usually agreeing a review point after the first 5 or 6 sessions.

In between the beginning and the end, though, the first session varies greatly depending on you. You might have a very clear idea of what you need to ‘get off your chest’ and the relief of having a space where you can do that means that you don’t need any help to get started. This can be especially true if you don’t have much opportunity to talk to other people about how you feel, or if you’re anxious about burdening people by telling them.

At the opposite extreme, you might not know where to start. If that’s the case, then I may ask you some questions…………..

Things the therapist is likely to ask about:

More information about why you’re seeking counselling

-and why now? Has something changed or brought things to a head?

Your previous experience of therapy

If you’ve had therapy before, I want to know what you found helpful or unhelpful, partly because I don’t want to do more of the unhelpful stuff, but also so I can look out for similar dynamics repeating in our relationship so that I can flag them up and we can talk about them; they might be a feature in relationships in your life generally, so we could learn something from them.

What do you want to GET from counselling?

If this is where you are now, where do you want to be? You might not know at this point, in which case we’ll come back to it at some point down the line.

Your current circumstances

Your living situation, significant relationships, occupation – this helps me understand things like support networks that you have available to you and factors that might contribute to your overall wellbeing.

Your family of origin

Information about what it was like for you growing up can be really useful as it’s likely to influence your behaviour and relationships as an adult, and getting more understanding of ‘no wonder I do this when I had that experience as a child’ can help you be more forgiving and compassionate to yourself.

Lifestyle and self-care patterns

Mental and emotional health is completely interwoven with physical health; there may be changes you want to make at a practical level that will help you mentally.

Anything that feels important to you about your identity or sense of self

You may have a very strong sense of who you are – or you may not know at all.

All these areas may have a bearing on why you’ve decided you want to have therapy, and talking about them can help you better understand yourself. We might not get to any of them in the first session, but I’m likely to ask you more about them at some point.

Reviewing how it’s going

It’ll take us at least a few sessions to settle into a rhythm and get used to each other. I normally suggest that we review how it’s going at session 6 (assuming that you’ve decided you want to carry on that long).

therapy helps you find your way (robert-ruggiero-unsplash) — *Image: Robert Ruggiero on Unsplash*

I’ll ask you how you’re finding the experience and I’ll share things that I’ve noticed – patterns that we get into, things I’ve not asked you – to see if they feel significant. I’ll want to know what has felt helpful, but I’ll also ask what has felt challenging or unhelpful, and what you think I or we might do differently – for example – do you find it difficult to stay on topic, and want me to flag up when you’re going off on a tangent? Do you feel as if you’re trying to guess the ‘right’ answer when I ask you questions?

Contracts and goals for counselling

I see my role as being to help you change. That might be:

making changes in your life
changing the way you respond to situations, circumstances or people

So, when we review how it’s going, I might ask what you want to change. Sometimes people find this a difficult question to answer – either because they don’t know, or because voicing what they want to be different, out loud, feels risky. But that’s useful information for both of us, too, as there isn’t a right or wrong answer to this question.

You’re the expert on you, and it’s your right to direct the course of the therapy. It might be that I’m not prepared to agree to work towards the change you want, in which case I’ll say so (gently!) and why. Usually this will be because I don’t think the particular change is within your – our – power.

For example

You might say you want to change the way other people treat you.
I’d point out that we can’t make that change as you don’t have control over other people’s behaviour, and suggest that we could focus on changing how you respond if other people treat you badly.
This might involve, building your confidence in speaking out; choosing not to engage with such people; or developing your self-compassion when you feel bruised by the behaviour of others.

And if my suggestion doesn’t feel right for you, we can carry on negotiating, or we can agree to park it and come back to it. From time to time I might check with you whether the goals we’ve agreed are still relevant or whether they need tweaking.

Is it just the client talking and therapist asking questions?

To an observer, a counselling session might look like two people having a chat. It’s known as talking therapy, after all. Often at the start of our relationship, a large chunk of sessions might be you telling me your story – what’s caused you to get in touch. Early in therapy, I’ll probably ask you more questions about your life now, and your history, as I try to get more of a sense of who you are and the influences that have shaped you.

walk and talk therapy (georg-arthur-pflueger-unsplash) — *Image: Georg Arthur Pflueger on Unsplash*

I don’t tend to give advice and certainly don’t tell you what you should do. But equally, I don’t hold back on information which might be useful to you, and so will sometimes share models to help you understand your thinking or behaviour patterns, or introduce some basic neuroscience – this can be helpful in reassuring you that what you see as ‘something wrong with me’ is often a normal biological response to past experiences.

I might also share exercises for you to try inside and outside sessions. Sometimes we’ll agree homework tasks that we can discuss from session to session.

Sometimes I teach a practice called ‘Focusing’ (read about it here) during a session. This is somewhat similar to mindfulness. It can be really helpful as a way of learning to respond to very strong emotions in a way that doesn’t involve avoiding them or being driven by them; instead, you can learn to acknowledge that they’re there and ‘sit next to them’ which can help lessen the intensity of overwhelming feelings.

Doing this in session means that I can help you pace how you do this, a little at a time, especially if you find the thought of engaging with strong feelings, such as anxiety, shame, or fear, is really scary, and worry that they’ll take over – using the session as a space to practice in can be helpful.

Focusing can also be helpful when you’re not sure how you feel, or when you feel numb – it can help you tune in to the feelings that really will be there, below the surface.

Talking about boundaries

The counselling relationship is a very specific one, like no other. We’re often sharing things that are really intimate, revealing the most vulnerable parts of ourselves. And yet this is happening within one 50-minute session, once a week (or whatever frequency we agree).

I’m firm about the boundaries of the relationship, both for the client and for myself. When we sign our agreement to work together we’re also agreeing the parameters within which that takes place. I don’t engage in conversations outside sessions, other than administrative ones where something unforeseen happens and one of us needs to rearrange the session.

This doesn’t mean that I’ll ignore you if you contact me, and it doesn’t mean that we can’t agree extra sessions sometimes if you’re in distress, but – as I don’t offer a crisis service – in general, we’ll keep to the principle that therapy takes place within the session time boundaries.

Lucy Hyde online therapy setting boundaries (image jan-canty-unsplash) — *Image: Jan Canty on Unsplash*

This is partly because I take my responsibility as a practitioner seriously, and that means taking my own self-care seriously; I’m not good at multi-tasking and need to keep my work and leisure time separate.

But it’s also because many clients I’ve worked with, struggle to maintain good boundaries, which can lead to various difficulties, such as burning out because you can’t say no when someone asks you to do something. My maintenance of boundaries models to you as a client that taking care of oneself is important; this is much more effective therapeutically than simply telling you that boundaries are important without practising what I preach.

In P art 2 of this blog I’ll talk more about how ‘modelling’ by the therapist is a key part of the effect of talking therapy, as well other aspects of how the therapist and client relate, and I’ll delve a bit further into the internal changes that take place during the therapeutic experience.

Everyone’s experience of therapy is unique because every relationship between two people is unique. If you want to know more about what it might be like for you to work with me, please get in touch and we can have a chat.

Therapist heal thyself

Lucy Hyde on 1 February 2019

This week I’ve been fighting a bug. (You don’t need to feel sorry for me, I’m doing a great job at that.) As I decided each day whether to go ahead with client appointments I’ve been reflecting on what was The Best Thing To Do – for me and for my clients. Never an easy one to figure out, this is even less clearcut with online work when the factor of “Is it in the best interest of my clients to be infected with my snotty bug?” is removed. And I don’t have the additional effort of hauling myself through the cold to a rented room in the city.

I’ve been remembering an article I read when I first started working with clients which spoke of the ethical requirements of self-care. That as therapists we have a professional obligation to look after ourselves so that we are in the best possible position to look after others. At the time I read it this was gold for me; if I had a duty to look after myself it meant that I would do it, as I could circumnavigate the internal messages that told me I was being self-indulgent.

Doing self-care ‘right’

The downside of my interpretation of this requirement is that my tendency to ‘do things right’ then kicks in, in the area of self-care, too; I find myself asking myself if I’m short-changing clients by working when I’m not 100% in peak physical and mental condition (i.e. coming down with a cold). That battles against the belief that my clients need me, that I’m letting them down by cancelling. (As counsellors we sometimes forget that our clients continue to live and function OK the other 167 hours of the week that we’re not with them.)

I’m sure my perspective is skewed by being inside the therapy world, but sometimes it feels to me that counsellors are particularly demanding of themselves and each other in the need to do things right. Counselling attracts people who care, who want to do well for others, who want to ‘make people happy’. But sometimes we can be blinded to the value of making mistakes, of having to make a judgment call in a fuzzy situation. Black and white decision making is so much easier!

Is it OK for counsellors to have needs, too?

Self-care isn’t all chocolate cake and scented candles, as has been pointed out before. In this context – of whether or not to cancel appointments – it’s not just a question of feeling sorry for myself and curling up under a blanket. Even where I may have felt anxious in anticipation, often I feel energised after an appointment – something about being so focused on that person, about being allowed a little way into their world, about our relationship, about the magic that happens in therapy. Is depriving myself of that feeling self-care? The total focus that I bring to a counselling session means that sometimes I feel as I’m ‘coming back into the world’ afterwards. It’s therefore an opportunity for me to be centred on something other than feeling under-the-weather – surely a form of self-care?

And as therapists we often feel uncomfortable talking about the reality that our work is also our livelihood – we don’t like the idea that we’re charging people a fee for ‘being nice to them’. (Reframe: therapists are people you pay to teach you how to care for yourself.) We need to make a living, and I would be dishonest pretending that potential loss of earnings isn’t a factor – financial survival is self-care too. There’s a practical business aspect to this though: we need to be ‘good-enough’ therapists otherwise our clients won’t come back. If we’re putting ourselves under pressure or making a habit of working when we’re not up to it, that won’t help the bottom line.

Giving it our best guess

All of the above comes with the caveat that we need to not push ourselves to extremes – either of overwork or of self-care! As an example; today I felt I was functioning at 85%; I went ahead with the appointment; I did feel I had more energy afterwards but I knew also that I had recovery time, a buffer of a few hours before the next client.

I have worked in jobs where I would go in when I was feeling rubbish – ‘presenteeism’ we called it in the HR world – because there was stuff that I could do that took less of my energy, and because I believed I had to ‘look keen’. I’ve also worked in jobs where I really needed to be 100% fit to cope with the demand of the role. Being self-employed, the only person I’m fooling is myself, and I just need to make a judgment and make the best of the situation.

As a therapist part of my work is modelling behaviour to the clients I work with. What am I modelling if I feel like shit and go to work anyway for the sake of my client? That the other person is always more important than the self, that I have to rescue them?

Sometimes there’s no formula

Instead I need to check each day as it comes with the information that I have; am I fit enough to work? And check at the end of the day; was I a good-enough counsellor? If some days I decide I would have been better taking the day off, that’s information for the future. And that way I’m modelling what it is to be human, that there are very few black and white decisions and that being human is good enough.

***As a footnote: the week after I wrote this, the bug really kicked in, totally flooring me. At one point I started to wonder if I would ever be well again. This was a good reality-check to my musings; there was no way I could have worked in that state – I could barely even think, let alone ‘focus on my client’. It was a reminder that sometimes there are black and white decisions!

References:

‘therapists are people you pay……’

What self care really means