What happens in therapy? – PART 2

Lucy Hyde on 30 May 2022

How does counselling promote change?

Earlier in the year I published ‘How does therapy work? – Part 1’, which talked about the practicalities of what to expect when you start counselling for the first time.

But that question – ‘How does therapy work?’ – can be answered in another way.

What is it that makes talking therapy an effective resource for helping you feel better?

What processes are at work there?

“Can I fix this problem in me?”

Many clients come to counselling, believing that if they could just understand WHY they feel so depressed, or anxious, or stressed, or angry, they would be able to do something about it. It seems like a no-brainer, right? It seems such a logical process:

5 self reflection Lucy Hyde online counsellor (image Ben White on unsplash) — Image by Ben White on Unsplash

Something’s broken
It needs fixing
If I figure out what it is I can fix it
Then it won’t be broken anymore

We can expend a lot of energy in the trying-to-fix, and often exhaust ourselves with thinking round and round a problem before we even get to point of finding a counsellor, eventually deciding we need an expert who’ll be better at fixing or figuring-out, to help us with the WHY.

But that’s NOT how therapy helps.

More understanding about ‘root causes’ CAN be helpful – but only if it encourages you to take a more compassionate attitude to yourself. In terms of ‘fixing the problem’……….

It might be that the reason for the depression, anxiety or stress is something that happened to you – and you can’t go back and change that
It might be that we’ll never know exactly why you have symptoms of anxiety or feel so angry – because you can’t remember everything that’s ever happened to you in life

repair tools in container with hammer and screwdriver — Photo by Anete Lusina on Pexels.com

If therapy isn’t about fixing problems – what IS it?

The way I see it – it’s all about the relationship.

The relationship you have with others.
The relationship you have with yourself.

The truth appears to be that many human struggles, from phobias to obesity, are consequences of evolution and not deficiencies of character. Identifying problems that we hold in common and developing methods to circumvent or correct them is a solid foundation upon which to build a therapeutic alliance.
Cozolino, 2002

What is the therapeutic relationship?

Asay and Lambert (1999) researched the factors that influenced the effectiveness of therapy. They found that the biggest contributor towards how well someone responded to therapy is ‘client variables and extratherapeutic events’ – i.e. what other shit is going on in your life, what supports you have around you, and how motivated you are to do the necessary work in order to make changes in your life.

The second biggest contribution – 30% – is the therapeutic relationship: the relationship that the client and the therapist form as they work together. This is why it’s important to find someone you feel comfortable – or comfortable enough – to talk to. You need to be able to trust your therapist. You need to feel safe in order to be able to explore those feelings.

Lucy Hyde counsellor talking helps — Image by Mabel Amber on Pixabay

I think of therapeutic work as being about GROWTH (I want more of myself) and RECOVERY (I want to feel less wounded by what happened to me).

Both growth and recovery need to be nourished in an environment that feels safe enough, as the client will at times be feeling very vulnerable and exposed as they reveal their innermost hopes and hurts. The therapist won’t laugh at, or criticise, these tender, vulnerable parts – and for some clients, that experience of compassionate, loving attention may never have occurred before. Seen in this light, the therapeutic relationship really is healing.

Making changes

Another important aspect is CHANGE – which is presumably what you, as a client, are looking for. If you’re content with things staying just as they are, you’re probably not going to look for a counsellor. So, there’s something you want to change, whether it’s changing an aspect of your life situation, or changing the way in which you feel about something or somebody (including yourself). Both involve you needing to do something different in terms of your behaviour – from changing the way that you talk to yourself, to taking steps to change how you live your life.

Lots of research has demonstrated that changes take place within the brain during the therapy process. Although the most significant change and learning takes place during the first seven years of life, the brain continues to change and adapt throughout our lives, as we do new and different things. This is what’s meant by neuroplasticity.

When we encounter new situations or experiences (for example, the experience of believing that another person – the therapist – really wholeheartedly accepts us just as we are), we develop new neural networks. These networks get stronger each time we repeat the same experience – it’s a bit like walking over the same route repeatedly. A path gets clearer as we use it more, and the old path, as it gets less used, gets overgrown.

Lucy Hyde counselling outdoors East Lothian

The most recent research has demonstrated that brains have evolved socially – i.e. that the brains have evolved to connect with other brains, which explains why we can be influenced by the feelings of others. When people feel something we feel it too, by the brain creating an internal model of the other. So the therapist can influence the brain of the client by modelling and attunement; I’ll say more about this later.

There’s a great clip by Louis Cozolino talking about this here:

Within the relationship between therapist and client, a number of different experiences may take place, that support you, as the client, in making changes. These include:

having a neutral space with someone who has no connection to your life situation
hearing yourself say things out loud for the first time (and having them offered back to you)
being in a relationship with someone who accepts the whole of you just as you are
making sense of your thoughts, feelings and behaviours and where they may have come from
learning and practising ways to change your relationship with yourself
finding resources to improve your wellbeing
bringing your attention to how you and the counsellor relate to each other (helping you choose a different way of responding in relationships with others)
being able to experience strong emotions and still be OK
subconscious-level experiences, such as getting your emotional needs met

Let’s look at each of these in more detail.

Opening up to someone neutral

“This is the first place I’ve had where it felt OK to say how I really feel.” That’s what Mandy*, who’d got in touch because of overwhelming social anxiety, said to me at the end of her first session. And many, many clients say a similar thing when I ask them how it’s been – that first occasion of speaking to someone, where you don’t worry about the impact of what you say on them, is so DIFFERENT.

Sometimes, you might not even realise how much you self-check or monitor when you’re talking to family and friends (no matter how much you trust them). You worry that if you really tell them how much it hurts, or how lost you feel, they’ll be frightened, or worry about you, or feel that they have to do something to make it better. The relationship between counsellor-me and client-you is different from ALL of those, and that means that you actually get to air those thoughts and feelings that generally just keep buzzing around inside your head, and……..

Listening to your inner child — Image by Paolo Stefanelli

Saying things out loud for the first time – and hearing them

The experience of hearing your words reflected back when you share your thoughts and feelings can be very powerful. Speaking out lets that part of you that feels stressed, or angry, or ashamed, know that it’s OK to share that; and to have that received with empathy and understanding reinforces that sense.

Even if it’s not the first time you’ve spoken to someone about what’s going on for you, often people’s responses are something along the lines of ‘oh, yes, that happens to me too, isn’t it awful’ or focused on figuring out how to fix your problem, both of which don’t really make space for your feelings. When I offer your words back to you, you know that you really have my full attention, and that it’s important to me that I really hear and understand just how it is for you.

Being accepted just as you are

You’ve probably come to therapy because you want to change something about your life or about yourself; you might think there’s something ‘wrong’ with you. But although I’ll talk about what you want to be different in your life, my starting point is that you are an OK human being just as you are, right now.

That doesn’t mean that I won’t be able to see that some behaviours or thoughts you have may be unhelpful, or hindering you, but I believe your core, your fundamental being, is right.

Making sense of thoughts, feelings and behaviours

Probably, as we talk, we’ll discover that those behaviours and thoughts and feelings mentioned above, are actually a pretty logical and normal response to your experiences in your family, in your life, and in a society, culture and world, that is frequently dysfunctional and restrictive of natural human growth. You might be reading this and thinking “but nothing bad happened in my childhood”, because a frequent narrative is that unless you’ve experienced ‘capital-T-trauma’ you should be a fully-functioning confident adult.

However, there are many aspects of 21^st century life that discourage us from following natural healthy tendencies. These include:

excessive exposure to other people’s lives via social media, encouraging us to make unhealthy comparisons;
product marketing that is designed to play on our insecurities, promoting a sense of not being ‘enough’;
political and social attitudes that put increased emphasis on the individual rather than recognising collective, community responsibilities for each other; and
disconnect between a philosophy that economic growth is appropriate or desirable, versus the real existential threat to life – via the climate crisis and unequal access to resources – that such a philosophy promotes.

Emotional distress is a natural response to living in today’s world, no matter what your individual history is.

big waves under cloudy sky — Photo by GEORGE DESIPRIS on Pexels.com

Getting a better understanding of the links between how you feel and the context of your life, while it doesn’t ‘fix the problem’ in itself, can help you be more accepting of your emotional experience. It can also help you recognise those areas that are outwith your control, and those areas that you can do something about, so that you can choose where to focus your energy to make changes.

Developing a better relationship with yourself

The experience of me accepting you just as you are, right now, combined with greater understanding of why you have the emotional experiences that you do, are really powerful in supporting you to shift from a self-critical to a self-accepting attitude.

In addition, I’ll often point out the language that you use in talking about your thoughts, feelings or behaviours. Language can reveal a punitive attitude to yourself that you may not have realised you had; a common example is using the word ‘should’ – “I should be doing such-and-such” which implies that you are failing if you’re not doing this.

Noticing this, and making small changes subtly shifts your attitude towards yourself – in this example, replacing ‘should’ with ‘could’ is softer, more permission-giving, less judgmental. The language that we use in relationships is powerful, and that applies in your relationship with yourself too.

I’m interested in ALL the thoughts and feelings that you have, even – in fact, especially – ones that seem contradictory, inappropriate or unattractive, and I’ll encourage these different aspects of you to get an equal say, possibly in contrast with your previous tendency to squash them down or ignore them. As I do this, I’ll support you to make space for these parts yourself – which usually leads to you realising that they’re not as scary or unpleasant as you thought they were, and you’ll discover that you can develop a compassionate attitude towards them.

Finding resources to help your wellbeing

There are two aspects to this, as one place you’ll find resources is within yourself. There’s a good chance that, when you’re finding things difficult, there are tools that you already know help you. In fact, one of the solutions to helping you feel better, can be to do more of what you’re already doing, or to remind yourself of things that have helped in the past that you’ve stopped.

You might say to me “but I’ve been doing my yoga / getting out for walks / going to bed early so I should feel OK” – yet sometimes our need for what resources us is greater than at others, and recognising that can be helpful.

The other aspect is looking for new resources. I’ll encourage you to come up with your own ideas, sometimes by us exploring together what already helps or hinders you in feeling well, and developing further ideas from this. I might also make suggestions based on my experience of what other people have found helpful.

I’ll ask you to focus on the smallest possible next step you can take, because building things up gradually is more manageable. The experience of successfully making a small change is more motivational and encouraging of hope, than trying and failing to make a big one!

How can I change my habits? - phone counselling

Understanding your patterns of relating

You and I can learn a lot about the way you are in relationships, by noticing what happens in our relationship – we’ve got really valuable information playing out in real time in sessions. For example, when I first started working with Mahmood* he would sometimes take a long time to answer questions that I put to him, and I could see that he was thinking hard before he replied. After a few sessions, we reviewed the work together and I discovered that at these times he was working hard to try and guess the ‘right answer’ to my question – his focus was on giving me what he imagined I wanted. This was relevant for his process in relationships generally, where he found it difficult to pay attention to his own needs as he was so concentrated on keeping the other person happy.

Discovering this meant that when I saw this happening, I could bring his attention to it and we could notice what his internal experience was in those moments, paying attention to the part of him that felt it had to keep the other person happy, and checking out what it needed. Mahmood was also able to experiment with not giving me the right answer, or with telling me when my questions didn’t make sense or feel relevant, noticing what feelings this triggered and how he could learn to tolerate them. The therapy session can be a safe enough space to try a different response, before taking that different behaviour into the outside world.

Developing resilience and recovery

Often clients say to me at the start of our work together that they want to get rid of a feeling – of anxiety, or anger, for example. I’m clear that I won’t help someone to ‘get rid’ of any aspect of themselves – it doesn’t fit with my philosophy of the whole of that person being OK. As mentioned earlier, feelings are a response to a situation, a response that has been a natural, logical step for some aspect of that person at some time in the past, even if with their grown adult perspective it may not seem helpful now.

Your way of dealing with an uncomfortable or overwhelming feeling might have been to try and ‘not feel’ it, to suppress it, ignore it, or distract yourself from it in some way – through over-eating, perhaps, or through getting very very busy doing things. In therapy we do something different – I welcome the feeling, and hold a safe space for you to gently turn towards it.

I’m there to pace you, to encourage you to pause when it feels like it’s too much, to help you get some distance between you and the feeling so that you’re able to experience it as part of you rather than feeling consumed by it. Almost always, you’ll find that you’re more able to tolerate these strong feelings than you realised.

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

And crucially, by giving the parts of you, that are anxious or angry or stressed, some time and attention, they will usually settle down and be less demanding. I use the analogy of a small child screaming with distress – you could shut her in a cupboard, but she’s going to carry on crying, whereas if you sit her on your knee and ask what’s going on she’ll begin to calm down.

Getting your emotional needs met

Sometimes the most profound and important work that happens in our relationship together is the hardest to see and articulate, that we may not talk about explicitly in sessions. This takes the form of interpersonal (between you and I) and intrapsychic (within your mind) growth and development.

As we work together, I influence your brain through modelling, where I demonstrate a way of being that may be different from other significant caregivers in your life. Modelling is much more powerful than verbal instruction – ‘Do as I do’ is hugely more influential than ‘Do as I say’!

I’ll also be influencing your brain through attunement, which is where I allow myself to resonate with your emotional experience, genuinely listening and caring about what is going on in your inner world. Attunement is fundamental for children to develop their ability to securely attach to others, but sometimes we don’t get enough of this when we’re little. The therapy relationship is ‘reparative’ – repairing the deficit. As we work together we create the optimum conditions for your inner growth and development, supporting you to be more able to meet your emotional needs – both in your responses to yourself, and in your ability to voice your needs to other people.

This is one of the seemingly ‘magical’ effects of therapy, that you can start to feel better, to learn to like yourself, by the experience of being in a relationship with someone that is reparative and healing of your previous wounds.

Talking it out Lucy Hyde online counsellor (taylor hernandez on unsplash) — Image Taylor Hernandez on Unsplash

All of the above experiences happen over and over again during the counselling relationship. There may be some moments where it feels like a lightbulb goes off in your head, and something big changes, but more often, in my experience, the process of therapy is one of re-learning or adjusting your way of being.

It’s not a straightforward linear process where you steadily feel more and more like the person you want to be. Shit will still happen and you’ll sometimes be triggered by it and react exactly like you did before you started counselling. The difference is you’ll be more familiar with, and understanding of, those reactions and can use your new learning to recover more quickly from those experiences.

Effective psychotherapy or counselling is a transformation that therapist and client facilitate together by allowing ourselves to really connect to each other in relationship. It’s mutual work – not something ‘done’ to the client by the therapist, but something that is built together. Like any work, it can sometimes be hard, or a trudge, but it’s sometimes fun and enjoyable! Importantly, to be able to work together to create something, client and therapist need to be able to establish a good-enough, safe, trusting relationship where both can be vulnerable to being impacted by the other.

Psychotherapy is not a modern intervention, but a relationship-based learning environment grounded in the history of our social brains.
Cozolino, 2016

If reading this has been helpful, you might also want to check out ‘What happens in therapy – Part 1’ where I talk about the practicalities of what’s involved from that very initial contact.

And if you think I’m someone who you’d like to try and build that therapeutic, growthful relationship with, please g et in touch.

* not clients’ real names

References and further information

The empirical case for the common factors in therapy by Asay & Lambert

The Neuroscience of Psychotherapy by Louis Cozolino

Why Therapy Works by Louis Cozolino

There are various interesting articles and short videos by Dr Cozolino at drloucozolino

Counselling and neuroscience

Strengthening neural connections through meditation

What happens in therapy

What is attunement?

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.

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.

What I learned about myself from wild camping (and how I wasn’t anxious)

Lucy Hyde on 15 October 2021

At the end of September I took a solo trip walking and wild camping. In this blog I share my reflections on what it taught me, and the value of doing something new to learn about yourself.

Lone camping was a first for me. I’ve done plenty of walking alone, and I’ve camped with my partner occasionally, but I decided to do this 2-night trip, because the notion came to me one sleepless night, and I wanted to see if I could.

I was excited about the prospect of being in my own company for 48 hours. This feels like quite a new thing for me; traditionally I’ve sought out the company of others and am quite gregarious. But I’ve come to understand recently that partly, that’s because I didn’t like being left alone with my own thoughts, that being around other people was a way of keeping busy. AND (thanks to the lockdown experience) I realised that actually time alone is needed recovery time, as my people-pleaser aspect tends to be on alert when I’m around other people – I’m always trying a little bit harder.

Don’t get me wrong – I still enjoy spending time in company. But the idea of not having to think of anyone else – and in fact, being unreachable through circumstance (i.e. no phone signal) rather than avoidance – had an appeal. No one was going to expect anything of me for the whole of that time. I was going into country I’d not walked before. It was going to just be me, and my food for 3 days, and my ‘home’ for 2 nights, and the hills, and the birds. Writing this now, the idea of it seems exciting all over again!

And the reality?

Yeah, there were some moments when I was really happy to be in the middle of nowhere with the ravens, where I was excited to think “I’m doing it!” These mostly coincided with sunny bright weather and feeling confident having successfully put the tent up (or having successfully stowed it away).

There was some swearing– when I snapped a tent pole, and at the steady increase of the rain just as I arrived at camp.

There were NO moments when I thought “I wish I wasn’t here” or even “I wish I had someone else here”. (Though there might have been, had I snapped the tent pole when I was putting it up in the rain, rather than when I was taking it down on my last morning.)

And there was, more than anything else, a lot of just-keeping-going and not particularly noticing how I felt at all. It surprised me how much ‘in-between’, neutral time there was, given that I had imagined that, with all that time alone, I’d be likely to get lost in my thoughts, or to get busy worrying. Yet I found myself taken up with being, with getting through it.

For example, a day’s walk on fairly good paths and gently hilly terrain felt more of a feat of endurance with a heavy pack than I’d bargained for. I found myself going more slowly, taking smaller steps. I was careful to eat regularly, yet often didn’t feel particularly hungry – instead I was focused on making sure I had the necessary fuel to make sure I was capable of putting my tent up at the end of the day.

At some level, even though I wasn’t scared at the remoteness, I suppose I was aware of the reality of having to depend on me, of being careful of husbanding my strength, of not risking injury by sudden movements.

And this process, I guess, kept me very focused in the now, and that’s probably why there were very few points when I felt anxious. My anxiety is often linked to worrying about what I need to do, or anticipating problems (that may or may not arrive), or imagining or assuming what others think about me. Somehow, here, there was less space for worrying about the future: too much attention on ‘now’ (my shoulders hurt, how can I adjust my pack?) to leave room for anticipating problems; and no one around, or expecting anything of me, for me to worry about.

So what DID I learn from the experience?

A few things……..

Sometimes comparing your situation with others’ CAN actually be helpful.

This is not at all a maxim I normally believe in. Many times I’ve had a conversation with a client where we’re trying to undo their tendency to punish themselves because they think other people have it worse than them so they’re not allowed to find things tough. Yet in this situation I was doing something similar.

I was halfway through a book before I’d headed off to the hills – A Woman of No Importance by Sonia Purnell (check it out – it’s quite the adventure story). It’s a biography of Virginia Hall, who was an Allied forces agent during World War II, who built up and coordinated units in the French resistance. She had a prosthesis following a leg amputation, and the tale of her having to escape through the Pyrenees in winter with insufficient clothing and food are astonishing. Yet she survived, and even thrived, in gruelling conditions.

She came to mind when, 4 miles from the nearest available shelter, I‘d just pitched my tent in the pouring rain and had crawled into it, damp, trying to keep wet and dry stuff separate, and to get warm. In that moment I managed to make a little bit of space for the part of me that was finding it All A Bit Much and say “yeah, of course you’re finding this hard! You’ve not done it before”, and to remind myself that Virginia Hall had gone through way harder things and come out OK on the other side – and I would too.

What was important in this moment was my attitude towards myself. Instead of telling myself I wasn’t allowed to find it hard because my issues were too insignificant, I reminded myself that people can come through difficult times and still be OK, while also validating my reaction. (My Focusing practice helped with this – you can learn more about that process here.)

It’s OK to find something challenging even if you’re not the first person ever in the world to do it.

You wouldn’t think this was rocket science, but apparently it’s a lesson I need to keep on learning.

I’d borrowed the kit off a bike-packing friend, and I knew that ‘lots of people wild camp’. And that’s when the more unhelpful side of comparing myself with others kicked in. You know, comparing apples (people who are experienced) with pears (me, the novice). I realised, only when I was catching up with friends afterwards, that a part of me had assumed I wasn’t allowed to find my trip difficult at times.

When I was met with the Wow, that’s quite an undertaking – weren’t you frightened? I recalibrated that judgment of myself as somehow inadequate at not immediately being a comfortable camper. And even allowed myself a little glow of satisfaction that I hadn’t been frightened (well, not much).

On the upside, I can see, looking back, that my survival instinct actually prompted me, when feeling a bit low, to be compassionate towards myself and – in the moment – reassure the wearied bit of me that it was OK to find it a bit tough, so that the judgmental part didn’t take over.

Compartmentalising can make me miss the obvious.

The obvious being: carrying stuff is hard work. I know! Who could imagine?

What happened was: I looked at my route before setting off. My longest day’s walk was 11 or 12 miles. Quite a long way, but I knew it was within my capabilities, especially on good paths. I also packed up my rucsac, completely, a couple of days before going, so I could check everything fitted in, and put it on to see how heavy it was. Heavier than I’d usually carry on a day trip, but within my capabilities.

What I omitted to do was to put ‘long day’s walk’ and ‘heavy rucsac’ together. Oops. It didn’t take many miles before I was feeling that, in various parts of my body in turn. Somehow that principle I share with clients, of noticing when you’ve got more than one stressor in your life, cos the impact is greater, fell by the wayside…….which takes me onto my next discovery.

It’s surprising what you can do when you don’t have the option NOT to.

My walk was harder going than I’d estimated, AND it was also fine. By the time I’d realised the miscalculation of effort, I was well into the moors and would have had as far to go back as I did to continue. If my foot (or hip, or knee) was sore, the only thing I could do was adjust things slightly to see if that helped – and to carry on. And actually that knowledge stopped me focusing on the discomfort, and so I wasn’t as aware of pain.

This was a helpful learning for me. I really value listening to my body. But this experience flagged up that I can sometimes allow fear to stop me pushing myself – in this case anxiety about damage to my body, and worry that I can’t do as much as I used to (probably linked ultimately to a fear of age and even death). It reminded me of the key role that the brain has in the way we experience physical pain (you can read more about the mental – emotional- physical connections of pain here ).

I discovered that I can control time!

When was the last time you did nothing? Like, literally, NOTHING? I honestly can’t remember, prior to this experience.

I’ve got much better at giving myself a break over the last decade or so. Gone (well, mostly gone) are the days when I would feel inadequate or a failure if I hadn’t been somewhere new or achieved a significant task on a weekend. Now I let myself sit and read the weekend papers over breakfast for an hour or two, I potter, I lie on the sofa with a book for an hour.

But even though I don’t think of myself as ‘keeping busy’, actually doing nothing – that’s very unfamiliar. When I was camping, there was around 12 hours of darkness. I was in a tent I couldn’t sit up in. I had limited power and no signal on my phone. So I lay in my sleeping bag pretty much from 7pm to 7am, even though I wasn’t tired enough to sleep (and didn’t, much, even when I was).

And yet, most of that time, I wasn’t particularly bored. I was just, kind of………..there. Existing. Tuning in and out to the noises around me. Noticing my toes warming up in my sleeping bag. Wondering whether it was going to pish down again the next day.

It felt weird to be in that not-doing space.

Time behaves differently when you’re not doing. For many of us, that’s WHY we keep busy, right? We’re often scared of the empty space because we’re not sure what will creep into it. Empty space fosters anxiety, and over-thinking. We avoid it at all costs. The flipside of that is that we keep so busy that times passes quickly, the more so as we get older, and we end up feeling like we’re running out of it!

I felt like my two nights out were way longer than a weekend. So, perhaps a way of stopping time feeling like it’s going so quickly, is to stop ourselves – and just do nothing. How much time just disappears when you’re scrolling through social media, for example?

I’m not sure how easy I’ll find it to do nothing now I’m back home, surrounded by all the things that ‘need doing’, with my phone available to distract me. But I’m going to give it a go.

It’s good to do something new, even if it’s hard.

I feel like I gained a lot from this experience. That’s not consciously why I did it. I wasn’t on some mission of personal growth. And when it was challenging I thought “I don’t know if I’ll do this again”. But I learned some new stuff about myself because it was sometimes hard, and – as I told my therapist later – it feels like this experience is a little resource that’s sitting on my shoulder. I don’t know quite what to do with it yet, but I like that it’s there.

finding your way Lucy Hyde online counsellor

So…..would you take the plunge to do something new?

To be honest, I don’t recommend heading off on your own wild camping experience right now. Winter is coming (if you’re in the northern hemisphere) and nights are colder. But if there’s something you’ve thought you’d like to try but are a bit scared of, or not sure whether you’ll be good at it (hint: probably not, the very first time) I would really encourage you to give it a go.

Final tip:
if there IS something you have in mind – tell someone about it. In one step, this makes it more likely to happen. Getting to the point of telling someone is a move in itself – it can be scary, if you think ‘I can’t back out if I tell someone!’ – yet actually, that’s not true, is it? But if you tell someone you have a dream, it makes it a little bit more real. It brings it closer. And then it’s more within your reach.

walking in the rain Lucy Hyde walk and talk

References and further info:

Book: A Woman of No Importance by Sonia Purnell

Pain: Not all in your head, it’s in your brain

Focusing and how it can help manage anxiety

How to feel more in control by setting goals for the year

Lucy Hyde on 25 January 2021

Feel more in control Lucy Hyde online therapy

“You never know ahead of time what something’s really going to be like.”
Katherine Paterson, ‘Bridge to Terabithia’

Please note that this article was written at the start of 2021 and references dates accordingly.

At the start of a new year, I always feel a sense of hope. The year is spread out in front of me like a beautiful expanse of pristine snow just waiting for me to make a path off into the distance. Or indeed, rush off, fall over and flail around getting wet. Even the start of 2021 had that sense of hope, although I didn’t buy in to the fantasy that 2021 was going to be wonderful, as if we could somehow close the door on what happened in 2020 when it was still happening.

I like to set goals at the start of the year. I don’t like New Year Resolutions (you can read more about this in my blog ‘Drop the Resolutions’). Even the word ‘goals’ smacks of business and sales targets, when what I’m talking about is a reflecting on what I want for myself – but ‘goals’ is the word that seems to fit best, so bear with me!

You may feel that with everything still so uncertain in the world, there’s no point in planning ahead. Perhaps you feel as if you’re just keeping your head above water in the latest phase of the pandemic battle. But goal-setting doesn’t have to be about major life changes or dream holiday plans.

Reflecting on what you want in the medium- or long-term can be a way to regain some control of your life, and can help provide a sense of purpose to support you when you’re finding things difficult, especially if you approach it in a way that is compassionate towards those parts of you that may be feeling anxious or worried.

So how to do it?

How to follow your path Lucy Hyde online counsellor

This is the process that works for me. I like to do it with paper and pen; you could do it on your laptop – but what’s important is to record your thoughts somehow so you can go back to them.

1. Review the previous year
2. Set your goals for the coming year
3. Check how you’ll know you’ve achieved your goals
4. Consider what might get in the way
5. Think how you’ll support yourself to get there
6. Review and refine your goals
7. Choose your Word of the Year
8. Keep your goals under review

Let’s talk about these in more detail.

1. Review the previous year

OK, so 2020 was a bit of shit-storm in many ways, and there are very few of us who didn’t find some of it difficult to a small or MASSIVE degree. This exercise needs to include acknowledging that, and appreciating that you got through it and survived.

But you can still take a bit of time to notice what went well for you, and/or what you achieved. For me, although my business increased and I feel very fortunate in that, what was more of an achievement, was noticing that I’d prioritised work over me. Revisiting what I needed in terms of my life balance led to me wild swimming regularly – in the process, discovering something new.

Over the last year, the circumstances we’ve been living in have meant that many more people have struggled with anxiety, with low mood or depression, or with feeling they have no control. If you feel you didn’t achieve anything, try to step outside yourself, look at what you were up against and how you’re still here. No achievement is too small to acknowledge.

If you did set goals last year, where are you in relation to them? What got in the way (hm, let me think, was it by any chance a pandemic?) and what can you learn from that? I didn’t achieve ANY of my goals from last year, other than my target client hours, and I’m fine with that, because I believe I focused my efforts to the best of my ability in the 2020 storm and ended the year healthy and mostly content.

2. Set your goals for the year

Do you have some kind of idea what you would like from your year? Probably. But it can still be helpful to think about it. If you’re self-employed, like me, then there’s a temptation to assume the goal is to increase income – but this may not always be entirely within your control, and anyway may not fit with what you actually want deep down.

Some people find it helpful to look at where they want to be in 5 years’ time, and then reflect on what this might mean for the coming year.

And this doesn’t have to be about professional goals. I always include at least one non-work goal, sometimes more, depending on what’s going on in my life. If the idea of setting goals doesn’t fit for you, you could try the ‘average perfect day’ exercise, where you spend time dreaming about what the average, routine day in your life would look like in an ideal world, in detail, so you can focus your attention on the gap between ‘here’ and ‘there’. You can read more about this exercise at ‘Average Perfect Day’ .

Spend some time daydreaming to help you set some goals – ideally 3 at the most, so be strict with yourself!

3. How will you know you’ve achieved your goals?

Thinking about this will help you refine your goals if they’re a bit ‘woolly’.

As an example, if I set a goal ‘to write more’, how am I going to know at the end of the year if I’ve written more than I did the year before? And what am I writing? On the other hand, if my goal is that I’ll have published a blog per month……….. if I get to the end of the year and I’ve published only 6 blogs since January, I’ll know I haven’t attained that goal (here’s a clue as to what one of my 2020 goals was ?).

Imagine you’re at the other end of the year looking back. Think about how the You in 12 months’ time is going to know whether you’ve got what you wanted. Getting a sense of this now will help you celebrate, but may also help you see where things have got in the way of your achieving what you wanted.

Are your goals concrete and clear enough?

Setting your goals with the help of therapy

4. What might get in the way?

It’s tempting to avoid thinking about this……… but ignoring it can be your downfall!

a. How might you sabotage yourself or allow others to sabotage you? It’s all very well to have ideals but it’s easy for old patterns of thinking to cut in and prevent us achieving them, with the result that we feel bad for not getting there and then get into self-blame for feeling bad.

Here’s an example. My main goal for 2021 is to complete my Focusing Practitioner Training, which I’m partway through. In order to be able to focus on my own training this year, I’ve decided to restrict my workload – but I know that this’ll create some anxiety for me around ‘not being a real therapist’; this anxiety has the potential to push me to take on more work, thereby sabotaging myself by not leaving enough time for the training course.

b. What will achieving your goals cost you? With any goal of doing something additional or different, there’s going to be something sacrificed – time, energy, money, etc. With the example above, achieving my training goal will cost me money this year, as my earnings are going to be lower. On the other had, what you sacrifice may be something you’re quite glad to let go – a toxic relationship, for example.

It’s important to take the cost into account, so that you can be more mindful that you have made a choice to prioritise one thing over another.

5. How can you support yourself?

The flip side of No. 4!

a. What will you gain in achieving your goals? This can be useful to consider, alongside the question of what achieving your goals will cost you. You may need to allow yourself to mourn for what you have to let go in order to achieve your goals, but you can balance that against what you’ll gain – why do you want this?

b. What do you need to do or NOT do to achieve your goals? Look at your responses to how you might sabotage yourself. So, with my example; I need to say No to additional clients over and above what I’ve decided is an OK level for me to maintain alongside my training. I also need to review my goals on a regular basis, so that if I’m struggling, I can decide what to prioritise, and what needs reassessing.

c. What resources do you need, and who might support you? This question will help you be realistic; you need to have the resources to get to where you want – whether it be financial, or emotional, or something else. For example, I need to remind myself that social supports are important for me – to ensure that I maintain contact with the people in my life who nourish me. If you can’t see where you can get the resources or support you need, you may need to get creative – perhaps by discussing this exercise with a friend or family member.

6. Review and refine your goals

Once you’ve completed steps 3 to 5, go back to the goals you set, and consider again whether they feel achievable. The purpose of those last few steps was to help you set goals that are realistic. If we continue to live through a series of lockdowns for the coming year, will this affect the achievability of your goals? Are they within your control? Are there less ambitious goals that are within your control and would move you toward where you ultimately want to be?

There’s a tendency to think that setting yourself high targets makes you work harder. Well, that might be the case for some people, but for most of us, we’re already pretty good at seeing where we feel we’ve failed; we don’t need to set ourselves up to do that.

Can you simplify or reduce your goals? Can you make it easier for yourself? Setting a goal or a target or a to-do list that some part of you believes is ‘too easy’ is more effective and more motivational than setting yourself one that you feel you ‘should’ be able to reach. Trust me on this, I’ve been there.

Now – adjust or rewrite your goals if necessary.

Using goals to feel more in control of your path

7. Choose a word for the year

You might already have something in mind, stimulated by this exercise. For example, the word that floated up for me was ‘Choice’ as it feels particularly relevant when I’ve chosen to commit to a goal that is going to affect how much work I can take on this year. Reminding myself that of ‘choice’ when I think ‘I have to’ is going to be useful.

If you don’t know where to begin, you could try simply writing down the first 20 words that come to mind and see if one fits, or do an internet search for ideas, such as 2021 Word of the Year . There’s no right or wrong with this.

Once you have your word, stick it up where you can see it from time to time.

8. Don’t leave your goals just lying there

Once you’ve done this exercise, come back to your goals in a week or so, to give yourself ‘settling time’. Read them over and see if there’s anything you want to add or change. Then, consider what smaller steps you can take to move forward. Break your goals down into the very smallest steps you can take.

Looking at the interim steps in this way might be particularly important if your ultimate goal is, for example, dependent on an end to pandemic restrictions. At some point, we will reach a less constrained ‘new normal’, and so there’s a good chance that there are smaller steps you can take to get yourself into a good position. Don’t forget to include attending to your own wellbeing as part of this process; your ultimate success requires you to be resilient and resourced.

Then pop a reminder somewhere to review your goals monthly or quarterly. Life gets in the way and for sure at the moment there may be lots of reasons why you feel you’re just plodding on. So make time for an occasional review of what you thought you wanted at the beginning of the year; this isn’t set in stone, so check – are your goals still relevant? What can you do to get closer to them?

And finally………..

Setting goals at the moment can feel as if it’s just another thing to make life hard. I’m tired of hearing about people who’ve seized the opportunity of lockdown to become expert on the piano, learn a foreign language from scratch or write a book. But this doesn’t have to be an opportunity to make yourself feel shitter; reflecting on what you want in your life can give structure and focus and bring your attention to what you can control rather than what you can’t. And by approaching it in a self-compassionate way, you might even help your dreams come true.

If you know what you want but aren’t sure how to get there (or if you don’t know what you want) you might find it helpful to speak to a therapist to clarify what you want for yourself and how you might make changes to help you move towards your goals. Get in touch with me via Contact details or search in a reputable online directory such as Counselling Directory , BACP or ACTO .

Online therapy to help you find your path

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