Common problems
There are commonly identified problem areas in which many individuals need help. Some of these are listed below. Most of us, however, can name a cluster of issues in life, where we feel we constantly fail to be at our best, or just feel bad about. These personal experiences are not easily defined by a single problem description or diagnostic definition. For example, an unresolved relationship issues and/or hereditary/family background factors and/or poor workplace training and/or poor self-care/lifestyle factors/health issues etc., can all combine to ‘lock-in’ the experience of long-term anxiety and depression. Counselling helps ‘clarify the mess’, prioritise current issues, provide support and understanding and develop strategies to go positively forward with.
There is much in life that is challenging and painful. With the best will in the world, some situations may take a long while to shift or be literally impossible to change. Regardless of what you believe you can or cannot change in your external life, I believe focussed counselling can help you achieve a ‘improved experience of life’ and a greater (healthier) tolerance for life’s frustrations and hurts.
With training in better thinking, development of more helpful attitudes and the mastering of relevant useful strategies, many problems that have been ‘tolerated’ a long while, will appear different and more amenable to acceptance and change. Meeting regularly with a skilled counsellor/therapist, helps set a positive direction by introducing skill mastery, insight and new perspectives. New ‘tools for your toolbox’, if you like. It is remarkable how previously daunting challenges are made easier by having the ‘right tools’ handy, along with the confidence to use them.
There needs to be a positive chemistry, a compatibility of sorts, between counsellor and the person. I recommend speaking on the phone or corresponding via email to at least two counsellors to get a feel as to whether they are right for you. I also recommend not persisting in counselling with someone who seems to make you feel uncomfortable, inferior or you plain dislike. Not all counsellors were created equal, as they say, and counsellors, like friends, should be thoughtfully chosen. I know when I have sought counselling at various points in my life, I have been decidedly fussy in choosing the ‘right’ fit for me.
Counselling can help couples get off the misery-go-round of familiar negative patterns, aggravations and disappointments or deal with traumatic events like betrayal, loss and sudden change. Relationship counselling can also assist resolving stalled joint decision-making within relationship (e.g. regarding relocating, investing, procreating or in-law issues) in an otherwise conflict free relationship.
My partner counselling approach begins with an individual session each, where you can really ‘let rip’ on your issues without repercussions. This serves as a ‘de-briefing’ for you and a fact finding mission for me. I gather information regarding the history of issues in the relationship from your perspective and enquire into the patterns/personalities in your birth/childhood family, as well as your ‘other relationships’ history. I can also be better informed as to whether it is in both parties best interests to pursue couples counselling or depth (insight oriented) psychotherapy, or to be referred on to more appropriate services..
The first joint session 1. Offers feedback as to my interpretation of this ‘preliminary assessment’, 2. Makes clear the ethical issues in joint therapy or counselling. 3. Outlines my expectations as a couples counsellor and the conditions under which I may terminate counselling with a couple.
In the light of the problems (as each of you see them), I highlight where you agree what the problems/causes are and where you disagree. In further sessions I attempt to assist you recognize why these problems are arising, in the light of your childhood conditioning or ‘culture of relationship’ your parents/carers/siblings demonstrated, and your history of relationship from teenage years on. As much as we don’t like to admit it, our parents/carers/peers have influenced our mixed performance in relationship in fundamental ways.
In subsequent sessions I also begin to offer coaching you in ‘the art of mindful listening’ . A way to stay connected with your partner and be attentive, even when you are hearing things you disagree with, or plain don’t like. To be acknowledged (rather than interrupted or ignored), when you have something to say to your partner, creates enormous goodwill and can reduce or eliminate arguments, with very little effort.
Depression and sadness
If you are sad, dispirited, feeling flat and even angry, unenthusiastic or cynical about life and this has persisted for weeks or longer or has constantly come and gone for a much longer period, chances are you suffer a form of depression.
There are many websites dealing with the definition of depressive illness (eg blackdog.com.au). I recommend you google ‘depression’ and find out all you can on the topic before seeking the services of a counsellor. The comments herein about depression are not intended as an authoritative description/definition on the topic, they are meant to introduce my style of counselling response to depression, recurrent sadness, flatness of mood and negativity.
My approach is to first of all, find out the severity and type of depression you have. Then design a program to assist you to manage your depression. This would probably be in conjunction with your GP, and/or significant other. If your depression is of a type that may be better managed with medication along with psychotherapy or you have a strong personal opinion about this, we need to reach a clearly agreed understanding of our approach from the beginning.
Managing depression is about managing immediate life situations (including a recent triggering events) as well as managing thoughts (self-talk, inner dialogue), lifestyle (including diet and exercise) and managing relationships affected by (or affecting) the depression. Investigating whether medication can be of assistance (short-term or long-term) via a medical consultation, if this hasnt already taken place.
A counsellor can help by supporting you to manage and monitor your mood and choose behaviours, lifestyle and thoughts that minimise depression’s hold over your life. Conversely counselling can help you identify and minimise thinking and acting in ways that entrenches or re-inforces a low mood.
I don’t do counselling for depression any justice in this brief introduction to the topic. Hopefully, you will get a sense of some of my public perspectives on the topic anyhow. (Click link in title for more information)
Burnout and fatigue
Where our duties are put in front of our personal needs for long periods of time, we are candidates for fatigue. Long term fatigue can end in burnout. The original definition of burnout comes from Herbert Freudenberger (1980) who named an associated cluster of symptoms, including emotional exhaustion, pessimism, low energy, negative attitudes, constant dissatisfaction as well as an incapacity to ‘connect’ with others and positively relate.
For me, burnout assistance provides objectivity, strategy and support. I would look at why the burnout progressed in the first place exploring systemic issues at work and home. In addition I would assist insight to develop as to why a person let it get this far. I would challenge a person to explore the paradoxical ‘pay-offs’ for pushing oneself beyond kinder limits. Furthermore I would provide support and guidance for a person to develop tailored (situationally appropriate) strategies and durable skills and insights that assist to prevent future burnout episodes. (Click link in title for more information on burnout)
Stress and anxiety
Stress is a normal part of life. In small quantities, stress is good — it can motivate you and help you be more productive. However, too much stress, or a strong negative response to stress, is harmful. It can set you up for general poor health as well as specific physical or psychological illnesses like infection, heart disease, chronic relationship dysfunction or depression.
Challenging relationships and workplaces can lead to chronic stress, as can major life events, such as death of a parent, loss of (or threat to) livelihood, migration, war, disaster or persecution. Health issues can underly major stress as well, such as major illness or surgery, over-active thyroid, low blood sugar, chronic pain, and post-accident rehabilitation challenges. Persistent and unrelenting stress often leads to chronic anxiety and unhealthy ‘coping’ behaviours such as overuse of alcohol or drugs. I have spent considerable time working with population sub-groups who are particularly stressed (migrants, separating couples, refugees, trauma victims, retrenched workers, chronic pain sufferers).
I am particularly interested in ways people can ‘turn around’ chronic reactive anxiety or stress. I find it a priviledge and very satisfying to assist a person to be empowered towards no longer feeling a helpless victim of stress. I have taught ‘mindfulness practices’ since 1981, and of course, practice these skills myself. Much evidence-based studies of mindfulness have recently proven the effectiveness of such methods in combatting stress and depression. (You can Google this yourself if you like)
Counselling for stress, is no one-trick method. Managing stress also challenges, refines and extends individuals’ existing skills and capacities, to optimise more adaptive responses to stressful scenarios in life. This process has it’s beginnings, working phase and ending. Starting with fact gathering; the person telling their story and the counsellor enquiring about additional elements (e.g. earlier stress scenarios, level of support outside of counselling, what has been tried before). Next, taking a ‘Whole Person Psychology’ approach, a person’s core assumptions about life, core values, central motivators, lifestyle choices and challenges (diet, sleep, exercise, community and friendship interactions, spirituality/philosophy, intimate world, physical/psychological age’n’stage issues are all examined and reflected in the safe, yet exacting context of professional counselling.
No single counselling journey is the same in my experience, therefore I don’t ‘formularise’ my response to people with chronic stress. Suffice to say, my intention is to equip a person to better respond to current challenges as well as creating enduring new skills and understanding that is life enhancing. Freud first asserted anxiety was a sign of ‘trouble within’, unresolved conflict in the unconscious mind. Everyone’s life contains considerable stress. Our vulnerability to stress can relate to ‘issues pending and avoided’ in our subconscious mind. (eg childhood neglect, learning trauma, enmeshed relationship with parent) Counselling for stress can extend into depth psychotherapy, where appropriate, as ‘hidden’ issues are examined that underly the chronicity of stress in your life.
(click link in title for more information on stress)
Family therapy is a style of psychotherapy designed to identify family patterns that contribute to a behavior disorder or psychological distress and help family members break those habits. Family therapy involves discussion and problem-solving sessions with the family. Some of these sessions may be as a group, in couples, or one on one. In family therapy, the web of interpersonal relationships is examined and, ideally, communication is strengthened within the family.
Family therapy theory, in explaining symptoms of distress, describes family members as a series of inter-connected vessels. When ’emotional energy’ isn’t expressed in one vessel, it may cause another nearby vessel to overflow. It goes some way to explaining why therapists have this notion of distinguishing ‘presenting problems’ from ‘underlying problems’ when developing for example, an assessment of a distressed child.
Often a family in overwhelm comes for family therapy to make sense of the various distresses experienced (and dealt with differently) by family members. Family therapy can be effective when a collective trauma or stress has been experienced by the family. Examples in my experience have included death of a sibling, separation of parents, a car accident involving family members and a terminal illness or progressive disease suffered by a family member. (click link in title for more information on family therapy)
Divorce and separation
Divorce and separation present some of the most stressful and challenging times of our lives. Many couples have tried counselling before choosing to separate. Counselling (alongside legal advice) however, can still assist you as an individual, couple or family, with the emotional and practical challenges and consequences of your decision to separate.
(Click on above link for more information.)
Parenting support
Counselling helps create a healthy and nurturing family dynamic so all family members experience the family unit as more of a safe haven from stress, rather than a major source of it.
In my experience, parenting support is part and parcel of a general counselling relationship. Counsellor assessment of parents in distress generally look at ways a parent can support themselves better. (see Stress Management) Besides refining parenting skills, these include: developing a support network, finding time for self, improving partner communication and team parenting efforts, improving self-organising and stress management. Areas of self-care and lifestyle factors are also looked at. E.g. developing satisfying interests, fitness and dietary care, and financial/career issues.
Other areas to explore would be parental teamwork, relationship stress and other life stressors. Counselling may also explore re-inforcing the focus on the ways children are enjoyed, appreciated and connected with, by one or both parents.
Addiction
You can be addicted to anything not just substances like alcohol, drugs or tobacco. More common addictions are behaviours (comfort eating, gambling, obsession with internet porn, compulsive reading, complaining! even criticising yourself!) My efforts with people suffering a ‘very bad habit’, is devoted initially to exploring what are the payoffs for this habit. I don’t carry judgements about addictive behaviours, however the person with the habit usually does. The focus for me is on assisting you to create the richest and most fulfilling life possible for yourself, whatever you conceive that to be.
Finding out what you get out of the repeated ‘consumption’ or ‘behaviour’ is followed by looking at where it first arose and what was happening in your life at that time. Usually there are unresolved issues lurking right back there (repeating now), which your ‘bad habits’ paper over. It’s not so much as looking backwards as charting a course forwards, usually into areas you were afraid to go before, for lack of support.
Counselling for addiction aims to support you to question and clarify what you want from life in the short to medium term and support you to create the conditions for this to unfold. eg: Fictitious case example: ‘Bert’ is a sexually acting out (serial affairs) stressed out young father. It turned out that he was assisted to discover 3 things: deeper trust, sensuality and depth in his marriage; manage his communication, bonding and activities with his children better and assert himself at work so he didn’t have to be superman to earn the right to stay in the job.
Bert learnt to see that the sexual acting out was a symptom of his distress. A response to feeling exploited at work, taken for granted at home, and disempowered in life generally (or elements of insight along these lines). He also learnt that his father took to alcohol (or withdrew) to escape a boring job and kids he was clueless in dealing with and a marriage that disappointed. This all helped to make real and lasting changes in his life that made sense to him and were definitely enriching and satisfying to sustain. Bert was no longer a flirt :) because it no longer made sense or ‘felt right’ to do this.
Chemical addictions are a little different in that structures, (like commitments to not use or minimise use are very much part of the therapy). I don’t work with active ‘users’ or counsel people who are intoxicated. Generally alcohol or other drug users are well served in the public domain with government funded services. Having said that you may be a ‘functional alcoholic’ (if there is any such thing), hidden amongst the other 2 million Australians. I do a lot of work with those who wish to reduce ‘self-medicating’ daily or nearly daily with alcohol. You may have been drinking alcohol for years to alleviate discomfort such as stress, depression, uninspiring relationship, social anxiety or just to fit in. My counselling work with you would focus on creating several alcohol free days in a week and ‘skilling up’ in alternative ways to respond to personal, professional, existential and social challenges in your life.
‘Numbing out and dumbing down’ with alcohol doesn’t deliver a richer life, yet it does provide relief from chronic thought and support being ‘In the Here and Now’. Hence it’s attraction. It helps you avoid addressing issues like social anxiety, relationship disappointments, self-esteem struggles or depression. Unfortunately, its not without cost. We tend to act out with alcohol in regrettable ways and avoid relationship or’ spiritual’ depth or emotionally maturing in our lives, sometimes for decades!! Over time this leaves a hollowness, insecurity and depression that is hard to shake off, except through drinking or using again. It takes a fair bit of guts and determination to recognise this. Imagining there is a better life available to you and darn well doing something about it takes a fair bit of focus. Counselling can assist you to stick with your ‘deepest knowing on this score’. Offering coaching, support, challenge, encouragement and reality checks along the way.
Hope that offers some sense of my counselling work on addiction.
Click the link above for more information on addiction.
Grief and loss
Grief is a many-sided experience, affecting people quite differently. Grief can be said to be both the turmoil and rebalancing processes that accompany the experience of loss. Many other descriptions of grief and grieving are equally valid, just as are our many different styles of grieving. Grief can experienced not only over death of a loved one, but also a result of many types of losses. eg: One’s reputation; one’s physical faculties or mental abilities; a relationship; a job; a home; a culture; a dependable faith or trust; one’s health.
When we lose something precious to us (or even something we thought we didn’t value much at all) there is suddenly a vacuum or gap in how we thought of ourselves and how we previously constructed our world or what we presumed our world to be. This sudden absence or missing element creates mental and emotional challenges, so we work (consciously and unconsciously) to accommodate the loss in an emerging new picture of our world. For a period our world will be unstable, unknown or meaningless, until our sense of self and self-in-the-world, restabilizes or at least becomes familiar in the post-loss landscape, both within ourselves and outside ourselves.
At a time of grief, periods of both aloneness as well as intense personal support are necessary. As are both time-out from the usual routines as well as embracing the necessity to just be carrying on with everyday responsibilities. Also in this period, is the requirement of ritual honouring of what has been lost or very personal story telling of times before the loss. This usually needs both a private and shared form to be completed over time. Such private ‘honouring’ of a lost one (or what has been lost), doesn’t fit into a neat schedule such as funeral rites (or, in the case of the end of a marriage, the date of legal settlement or even the start of a new relationship). Paradoxically, ‘good grief’ could be said to ‘never complete’. In the acceptance of both the irreplacabilty of a loss and the ongoing awareness of a part of us the will forever pine for what has been lost, we find expression for our gratitude of what we had and the perpetuation of the qualities of the person or experience that was once physically present in our lives.
A significant element of grieving the death of a loved one, includes for many, establishing the normalacy of an ongoing link or avenue of communication with the one that is physically gone. This can be in active positive (and sometimes negative) recollections of times past, including them in on current experiences as if you are sharing these with them and even ongoing verbal dialogue with the deceased, both in thought, in art or writing and out loud. The experience of grief does not have to end to be complete. Rather the completion of a grieving process means a sense of loss is finally accommodated into life without dibilitating consequences; where your capacity to live a full and rewarding existence goes on, without guilt, sadness, anger or emptiness dominating your existence.
This brief snapshot of grief is by no means comprehensive. It is a simple reflection at the keyboard of some perspectives around grief I have found helpful, both personally and in my role as a counsellor over 30 years. My overriding sense of the role of a grief counsellor is assisting a person to ‘take the full journey of grief’, giving full expression to their unique grieving process (e.g. not persist at ‘being strong for others’) and to distinguish ‘good grief’ from ‘unhealthy preoccupations’, negativity or ‘stalled grieving’. Counsellors (generally) make great listeners and have the knack of not just assisting in the management of difficult emotional experiences; but turning these into positive opportunities for development and deepening as individuals.
I hope this brief ‘short take’ on grief and loss provides a sense of how counselling may be helpful for you in ‘grieving well’.
Sleeping disorders
There are many forms of sleep disturbance and many potential reasons for this. In general it is best to rule out (or rule in) organic and health related reasons for sleep disturbances. Having visited your G.P. (and/or your naturpath/herbalist etc) then the better sleep strategies can be developed that fit your circumstances.
When someone shows up in my counselling office with the complaint of poor sleeps, I usually see this in relation to broader contexts of a matrix of issues that are impacting on the individual. eg Unresolved relationship conflicts; toxic work environment; money troubles; cultural or social isolation; substance misuse, legal and illegal self-medication; recent traumatic incidents etc.
I would also look at an individual’s social, medical, relational and emotional history and attempt to build a picture of what unhelpful factors may be at play in a person’s psyche, that is compounding or underlying unsatisfying sleeps. The mind uses sleep to integrate and accommodate the waking experience. Brain chemistry also rebalances in REM and dreamless sleep. Ongoing sleep disturbances can lead to a spiralling personal, mental and emotional overwhelm and distress.
In counselling a sleep disturbed individual, I would sift through various factors such as the above and set several remedial strategies into play, testing out which avenues are turning out to be helpful and de-emphasizing those that are not. Specialized sleep clinics are an option to if nothing seems to be improving (all night monitoring of brain activity and physical aspects such as breathing).
I would look at assisting with helpful mental and meditative strategies just before bed as well as middle and late evening. I may liaise with a doctor for minimal medication if the situation is severe and unresponsive. I generally emphasize a wholistic approach to poor sleeps: eliminating caffeine post midday, optimal physical activity, improved diet as well as stratagies and skills to more successfully deal with challenging life issues and the unhelpful ‘head chatter’ that accompany them.
You can ‘google’ sleep disturbances for a more comprehensive picture of sleep disorders and it’s options for treatment and assessment. I am not a specialist in this area, however poor sleeps is a common ‘presenting symptom’ in many initial counselling consultation. It usually leads to an exploration of deeper and broader issues, that once resolved, result in improved sleeps.
Phobias and fears
Phobias (from the Greek Phobos or mortal fear) is defined as an ‘anxiety disorder’ where an object or situation is compulsively and irrationally avoided.
Treatment of phobias differs for the age and experience of the sufferer. Common phobias can be specific (dog, spider, heights, deep water, flying, open spaces) or general like social phobia, which include anxiety around groups or others, (familiar or unfamiliar), or variations like incapacity to join in conversations, or use public toilets.
Phobias can also be linked to recent or distant traumatic (or emotionally significant) event. A thorough grasp of a person’s history (mental, emotional, physical, psychological, social, and cultural) as well as a detailed map of their cognitive and mental world is necessary before embarking on the treatment of a phobia or overriding fear.
Whilst other options are available (like EMDR, hypnosis, classical CBT). I work with phobic individuals in a psychotherapeutic context, where the symbolism and unconscious processes around the phobia ae examined. I can employ forms of CBT and Eriksomian hypnosis (light trance re-patterning) in conjunction with the broader context of insight oriented psychotherapy.
Major life decisions
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Workplace conflict
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Giving up smoking
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Problem gambling
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Problem drinking
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Staff issues
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Vocational assessment
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Career planning
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Workplace rehabilitation
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Post traumatic stress disorder
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Confidence and self-esteem
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Panic attacks
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Pain management
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Workplace harrassment and bullying
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