Podcasts - on living and dying.

I came late to the podcast world, but now I'm in it - wow. I love them! I would say that they are my main source of media entertainment - whether listening whilst commuting, whilst cooking dinner or running (OK, jogging) at the gym.

I've wondered whether my affinity with podcasts is something to do with the nature of the long form interview, and how in many ways this is reflective of therapy sessions. Often for an hour, often two people in dialogue with each other, using the space to learn more about each other - there are certainly similarities.

Two podcasts that I have recently been introduced to and that I would like to share with you today are 'Made of Human', hosted by comedian Sofie Hagan, and 'Griefcast', hosted by comedian Cariad Lloyd.

Sofie describes her Made of Human podcast as about connection:

"I sit down with a lovely person and we talk about life. I want to find out how to cope with being an adult person. I want to find out how to deal with all of the confusing bits of life. All of the hurtful bits of life. I want to sit, for just an hour, with a great person and learn from them. And - if they have no idea how to 'adult', then that will be absolutely okay - at least we will have an hour of feeling like we're not the only ones in the world"

Guests include comedians, activists, authors and all round interesting people with their own stories to tell about how they mange to live in what can be such a challenging world.

https://www.madeofhumanpodcast.com

From talking about how to live, to talking about  how to cope with death...

In 'Griefcast' Cariad invites us to consider questions such as 'how do we actually grieve for someone?', and 'how does it change & evolve as we get older?'. She tells us that:

"My dad died when I was 15, and it took me many, many years to express what I had gone through, so I decided to create Griefcast, a chance to talk, share and laugh about the weirdness of grief, death, pain and agony, but with comedians. So, its not that depressing, I promise"

There's something beautifully moving about the gentle way Cariad and her guests explore this difficult issue, with humour and love and sadness. As a listener, it feels like a privilege to be invited  into each guests unique experiences of death and it has certainly made me reflect on losses in my life and my attitude to death. And, she's right - it's not that depressing.

https://www.acast.com/griefcast

Take a listen - I hope you enjoy these as much as I am.

Using Maslow's Hierachy of needs in the therapy room

We are seeing a steady rise in mental health issues including anxiety for young adults. ONS data on the lifestyles of young adults in the UK show that one in five 16-24 years olds reported mental ill health in 2014 [1]. Whilst there are likely to be myriad reasons for this steady rise, what I want to use this short article for is to consider how we can help young adults to prioritise self-care. 

As a counsellor working primarily with young adults I am surprised on an almost daily basis by their resilience and strength – whether in education, employment or another path, they invariably arrive to appointments on time, are ready to engage with the notion of therapeutic change and willing to place trust in me as someone who can work with them to help them achieve that. 

Many young adults that I work with are completing degree level education whilst holding down part-time employment and focusing on making themselves as employable as possible through internships and unpaid work experience. All while trying to ‘do it all’ - to go to the gym five times a week, to maintain functioning relationships and to respond to the uncertainty around geopolitical changes that they now face. 

What I don’t often hear about in the counselling room is how our young adults are looking after themselves – instead, I hear how their needs - both physical and emotional- are pushed down to the bottom of the list, if not off it completely.

Maslow’s hierarchy of needs

One way that I approach this with clients is to introduce elements of the theory of the American psychologist Maslow, and his hierarchy of needs (1943). Maslow presented a theory proposing that healthy human beings have innate needs, and that these needs can be viewed as a hierarchy. He suggested that until our basic needs are met - what he called physiological and safety needs – then higher needs could not be met. This is often depicted in diagrammatic form as a pyramid.

Holding an awareness of Maslow’s theory helps me when working with young adults who have sought counselling support for their mental health needs. Without wholly subscribing to his theory, I find the hierarchy of needs a useful tool for introducing the idea of prioritising physical needs when facing psychological unrest in the context of each client’s own lived experience.   

Using the pyramid can facilitate an exploration of the idea that without regular sleep, nutritious food and hydration we are unlikely to be able to achieve any higher needs which may in turn result in an increased sense of anxiety and stress. This feels particularly pertinent at this time of year as exams approach and deadlines loom - new figures from the NSPCC-run service Childline recently revealed that it delivered 3,135 counselling sessions on exam stress in 2016/17 - a rise of 11% on the previous year [2].

Sarah* was a 21 year old client who accessed counselling via her university as she was struggling with anxiety and low mood related to her academic work.  She shared that she was finding it difficult to get the motivation to attend lectures and to engage in them when she did attend and so was struggling to maintain the level of academic performance that she was previously proud of. She had started to isolate herself from friends as she was ashamed of what she called an ‘inability to just get on with it’. Through exploration of her lifestyle it became apparent that her job in a local bar meant that she was regularly going to bed at around 4am but then finding that she was waking just a few hours later as her housemates began to get ready for their day. She had maintained this sleep pattern for such a long time that she seemed surprised when I commented on it; she had normalised it and not considered the impact of a lack of regular sleep on her mental health. Spending some time exploring this with Sarah using Maslow’s theory helped her to make that connection and as our work continued she was able to consider changes that she could make which would allow her to establish a healthier sleep pattern. She began to see her basic physiological needs as essential which granted her the permission she needed to fulfil them.

Prioritising self-care is not an easy task, and one that we all occasionally need to be reminded of. The beautiful thing about self-care is that it can take many forms – whether it is a change to sleeping patterns, attending a kickboxing class or listening to a favourite podcast, there are always things that we can add to our lifestyles to help our overall sense of wellbeing. 

*Identity changed to maintain anonymity

Therapy books that have inspired me

I was pleased to be invited by the team at the great website welldoing.org.uk to submit a couple of reviews of therapy books that have inspired me throughout my therapy career. Narrowing this down to three books was extremely difficult! However, I managed to pick three very different books that have all contributed to my professional and personal development in different ways:

1. Psychotherapy and Process: The Fundamentals of an Existential-Humanistic Approach by James F.T. Bugenthal

In this book Bugenthal takes us on a wonderfully inclusive journey through the processes of psychotherapy from an existential-humanistic perspective.  He structures the book very deliberately, using stages of a journey to mirror the stages of psychotherapy. In the first chapter, ‘The prospect of a journey’, he introduces us to the theory behind his approach, whilst the second, ‘The traveller makes ready for the journey’, asks what the client brings to the therapeutic process, using excerpts from accounts of former clients to illustrate the myriad emotions that can accompany that first therapy session. The book continues in this vein, dedicating equal weight to the perspective of client and therapist as they face the different and sometimes challenging stages of their journey.  

The book concludes with the final chapter ‘The journey over, the guide reflects’ which includes some beautiful insights from Bugenthal’s own experiences as a therapist as he considers how he has changed as a result of participating in the lives of others. Whilst the author doesn’t shy away from including what is at times fairly dense theoretical knowledge, the inclusion of personal anecdotes and client case studies helps to contextualise the theory and distinguish this non-fiction read from other theory-based books.  As a therapist this book speaks to me on many levels, whilst reminding me of the value and importance of reflecting on the many journeys that I am privileged to embark on with my clients. 

2. Cutting it Out – A journey through Psychotherapy and Self-Harm by Carolyn Smith

A fellow therapist recommended this book to me when I was working with a young client who was engaging in regular episodes of self-harm; it was extremely helpful then and remains a text that I find myself turning to on a regular basis.  Presented as a novel from the unique perspective of the young female client, this book invites us into the complex world of therapy as we travel alongside both client and therapist on their journey of understanding. Given the subject matter one could be forgiven for expecting a challenging read, however one of the beauties of this book is the gentle humour that is interspersed throughout in the form of wry comments on some of the therapist’s interventions and as the client engages with her daily life outside of the therapeutic space.  

This is an extremely accessible book, presenting the complex issue of self-harm in a thoughtful and sensitive way.  Whilst it will appeal to therapists who work regularly with clients who self-harm, I also feel that it is a valuable read for those who self-harm or those who are in therapy, and for anyone looking to gain a client perspective on the somewhat private world of psychotherapy.

3. Mad, Bad and Sad – A History of Women and the Mind Doctors from 1800 to the Present by Lisa Appignanesi

This captivating book offers an insight into the way that the mental health of women has been viewed over the past 200 years. Beginning with the ‘Mind Doctors’ of 1796, Appignanesi takes us on a journey through the era of ‘madhouses’ and the first physician to liberate those incarcerated for madness from their chains, to an exploration of the cultural importance of Freud’s writings and the perhaps surprising insight that he championed women into the profession to the rise of the pharmaceutical industry and the increasing prevalence of using pharmaceutical drugs to ‘cure’ mental health illnesses.  At over 500 pages of complex ideas and in depth research, this is by no means an easy read – Appignanesi highlights the theoretical insights of Winnicott, Bowlby and Laing to name a selection – however her skill lies in using vibrant case studies to bring the theory to life. 

From Virginia Woolfe to Sylvia Plath, Marilyn Monroe to Susie Orbach we are invited to consider big ideas from a variety of perspectives.  The book is split into four parts spanning the 200 years – chapters that I found particularly interesting are ‘Hysteria’, ‘Mother and Child’ and ‘Body Madness’.  Running throughout the text is the encouragement for us to ask the question – why was the mental health of women considered as fundamentally different to that of men? This book answered many questions that I didn’t know I had, and created more that I am seeking the answers to.