It would not be true to let anyone believe that just because I am psychotherapist I have mastered fear and anxiety in all situations. Like many, I am feeling an under current of anxiety, as the world around me feels more unstable than I have ever known it as an adult and ghosts from the past emerge reminding me of how far I have come and that I still have a way to go. It feels as if it is one of those moments in life when we are all called to look inside and dig deep. I am being challenged to take stock and look to see whether the words I speak so easily to others can land on me in the way I hope they do with my clients.

I have always believed that effective psychotherapy works because the therapist continues to grow as a person and I know that this period of time will see me grow in ways I have yet to comprehend.  As part of me struggles to come to grips with what has seemingly knocked us all sideways in one way or another, I need to remember that we can’t ever tell exactly what will happen to us and nor should we try.The reality is that a great part of our lives lies in the hands of the unknown and that is deeply uncomfortable for most. Today, things are changing moment to moment and uncertainty fills the air and although spring feels as if it is just around the corner, there is an eerie feeling of waiting and not quite sure what the waiting is for. A starting point for myself is a commitment to staying positive, reminding myself that I have control over how I plan to react, feel, think and believe in the present and that no one guides the tone of my life, except me.

The rapid spread of the virus that causes COVID-19 has sparked alarm worldwide. The World Health Organization (WHO) has declared this rapidly spreading coronavirus outbreak a pandemic, and the Centers for Disease Control and Prevention (CDC) is advising people to be prepared for disruptions to daily life that will be necessary as the coronavirus spreads within communities. We need to stop to consider how fear not only weakens our immune system, but it can also create an unhealthy disregard for those around us. Images of people stockpiling toilet paper and empty shelves in supermarkets do nothing to comfort those of us who find the unknown terrifying. Fear and anxiety are powerful immunity suppressors and so I am working on getting as healthy as possible both physically and mentally so that in the unfortunate instance I catch something, I am strongly positioned to keep symptoms at a minimum and fight it with greater speed and ease. 

Victor Frankl wrote in his book, Man’s Search For Meaning “Everything can be taken from a man but one thing: the last of the human freedoms—to choose one’s attitude in any given set of circumstances, to choose one’s own way.” I am heartened to see communities coming together to take care of those who are most challenged at this time. Now is not the time to back off our older population, who need our love and support more than ever. Along with those that live alone and who are, perhaps, already feeling isolated and lonely with no one to share their fear and anxiety with on a day to day basis. It is easy to forget when you have the noise of loved ones around just how deafening the silence can be when you live alone. 

I would say be mindful of what you read. While no one source of information is perfect, some are undeniably better than others. Look for sites that rely on experts who use well accepted scientific analyses and publish their results in reputable medical journals. The CDC and the WHO, have a mission to inform and protect the public, with the WHO recently having added a myth busters page to its information to try and dispel some of the rumours that are circulating. 

I am rediscovering the art of knowing when and how to stop thinking, which helps me from fostering panic at a time when a cool mind and warm heart is needed to support my clients. With regards to my practise I am still operating and will continue to do so. For those who feel more comfortable I am happy to do remote sessions on FaceTime or Zoom. It is at times like these we need to reach other and be creative in how we do this.  Words like Self isolation and social distancing can make each of us feel very alone and it is in those lonely moments that we must remember that along the path of darkness there is always light waiting to be seen. As we face the next few months, let us be the light that shines on the paths of those around us that are struggling.  

I was privileged to be asked to work yesterday with a group who had been directly involved in the recent terrorist attack in Borough Market. With one of my specialities being that of a Trauma Therapist, I am continuously reminded of the resilience of the human spirit and how, sometimes it is out of the most horrific situations the most profound lessons are learnt. (more…)

Transference is a dynamic that most couples are unaware of and when I work with couples it is something that we explore that most find useful. www.thebookoflife.org explains perfectly how transference plays out in relationships.

‘You’re flicking through a fashion magazine and playfully suggest that your partner might want to make a few experiments with their wardrobe. How about a different pair of jeans or a new T-shirt, a duffle coat or platform heels? But at the mention of this possibility, your partner gets very agitated indeed: they scornfully declare that money is tight, they haven’t got any time, they have too many clothes already and why are you deliberately annoying them by making vapid proposals like this? This response is very off-putting. You only made a perfectly reasonable suggestion and now they are declaring war. You didn’t do anything. Their behaviour seems utterly out of proportion with what triggered it. You may conclude, as you have done on other occasions, that in some areas the person you love really does seem ‘a bit mad.’ This conclusion, though perhaps depressing, also feels strangely satisfying. At least you know what is up. Couple having serious interaction But we are all a ‘bit mad’ in ways that preclude such dismissive statements and demand closer and more generous examination.

For all of us, there are situations and behaviours which can be counted upon to elicit swift and powerful responses which don’t seem in any way in line with what is happening right now. Our behaviour seems not to fit what is unfolding in front of us. For example, someone we love is going away for a month, and tells us they will miss us very much indeed. They move to hug us. But far from feeling sad and tender, we just register numbness, pull away and can’t say anything other than that the weather is unseasonably chilly today. Or we return home to find there is a bit of a mess in the kitchen, but rather than taking this in our stride, we start to shout at our partner that the house is chaos and life with them has become impossible. Or a friend is only ten minutes late for our birthday party, but we are compelled to send them a text calling them an a**hole and asking them not even to bother coming.

These sort of behaviours don’t make any sense if we try to justify them simply according to the facts in the here and now (as we and their perpetrators are inclined to do). The clue to them lies in something known as transference – a psychological phenomenon whereby a situation in the present elicits from us a response – generally extreme, intense or rigid in nature – that we cobbled together in childhood to meet a threat that we were at that time too vulnerable, immature and inexperienced to cope with properly. We are drawing upon an old defence mechanism to respond to what feels like a very familiar threat.

In most of our pasts, when our powers of comprehension and control were not yet properly developed, we faced difficulties so great that our capacities for poise and trust suffered grievous damage. In relation to certain issues, we were warped. We grew up preternaturally nervous, suspicious, hostile, sad, closed, furious or touchy – and are at risk of becoming so once again whenever life puts us in a situation that is even distantly evocative of our earlier troubles. Perhaps a parent we loved left us for long periods to work abroad. They didn’t mean to but the pain was so intense at that time, we reacted by shutting down our capacities for affection. Our way of coping was not to feel, to grow numb – a response that we keep producing even now, 30 years later, whenever someone we love has to go away for a time. Or perhaps we had chaotic, unreliable parents whom we dealt with by rigidly organising our room, arranging books by size, and reacting with alarm at the slightest bit of dust – and even now, outer disorder ushers in a panicky feeling within that everything is out of control once again. Or we had a sister who was always late to events that mattered to us, or a mother who was both humiliating and obsessed by fashion.

The unconscious mind is slow to realise that things have changed in the outer world but sadly quick to mistake one person for another, seeming to judge only by crude correspondences; ‘someone we love’ or ‘a person coming to our party’ appears to be enough to confuse us. Because transference happens without us knowing it, we generally can’t explain why we are behaving as we are. We carry years behind us that have no discernible shape, which we have forgotten about and which we aren’t in a position to talk others through in a manner that would win us sympathy and understanding. We just come across as mean or mad. What we would ideally need is a guardian angel who can pause the present and carry our partners back to another time and place, to the moment when the neurotic defence that we are projecting originated. They’d be able to see the unreliable parents, the chaotic house, the loving but neglectful father, the fashion-obsessed mother etc. – and might be appropriately moved by what we had to cope with before we knew how to.

The concept of transference – and the accompanying idea of projection – provide a vantage point on some of the most frustrating behaviours that we ever meet with in relationships. And they allow us to feel sympathy and understanding where we might have only felt irritation. If we cannot always be entirely sane in our relationships, the kindest thing we can do for those who care about us is to hand over some maps that try to chart and guide one through the more disturbed regions of our internal world. In good relationships, people are ready to accept that they might be involved in transference. Ideally, we should all rationally disentangle and un-distort our transferences and explain them to others in good time. But it rarely happens and collectively we pay a big price for our ignorance. We keep making things tough for everyone by over- and under-reacting – and so our relationships are far harder than they need to be.’

Please feel free to contact me should you want to explore this or any other topic further.

In our society fewer and fewer people grow up seeing a strong relationship modelled between their own parents and so it comes as no surprise that it is not because of incompatibility that many marriages break down, but because the couple have no idea what it takes to make their relationship work.

As a relationship therapist I am often astonished when working with couples just how little they know about each other’s views on things that are of fundamental importance to a relationship. I see couples shocked in the realisation that they have never really talked about what their partners reveal to me, a complete stranger. Feelings, thoughts, hopes, dreams, disappointments and expectations that they had not known even existed which can be both painful and enlightening.

At the heart of a strong marriage is a strong friendship and like all friendships they need time and attention to be maintained. Communication is at the very core of any relationship and yet topics such as money and sex seem to be cloaked in mystery between two people who have chosen to spend the rest of their lives together.

Relationships that break down are usually as a result of a process of growing apart over many years as this poem describes: –

The Wall
Their wedding picture mocked them from the table.
These two whose lives no longer touched each other.
They loved with such a heavy barricade between them that neither battering ram of words nor artilleries of touch could break it down. Somewhere between the oldest child’s first tooth and youngest daughter’s graduation they lost each other.

Throughout the years each slowly unraveled that tangle ball of string called self and as they tugged at stubborn knots each hid their searching from the other.

Sometimes she cried at night and begged the whispering darkness to tell her who she was while he lay beside her snoring like a hibernating bear unaware of her winter. Once after they had made love he wanted to tell her how afraid he was of dying, but fearing to show his naked soul he spoke instead about the beauty of her breasts. She took the course in modern art trying to find herself in colors splashed upon a canvas and complaining to other women about men who were insensitive. He climbed into a tomb called the office, wrapped his mind in a shroud of paper figures and buried himself in customers. Slowly the wall between them rose cemented by the mortar of indifference.

One day reaching out to touch each other they found a barrier they could not penetrate and recoiling from the coldness of the stone each retreated from the stranger on the other side. For when love dies it is not in a moment of angry battle. Nor when fiery bodies lose their heat. It lies panting exhausted expiring at the bottom of a wall it could not scale.

Anonymous

I work with couples at all stages of relationship. I offer five weekly marriage preparation sessions, which allow couples to have the often forgotten conversations before walking down the aisle together. I offer sessions for couples having a challenging time. These can be anything from a fifty minute session, to sessions of up to four hours in one go. These allow enough time for issues to emerge and time to devote to creating a better understanding of what is happening to the space between the couple, which is ‘the relationship’.

In the words of Robert Louis Stevenson ‘marriage is one long conversation chequered by disputes.’ Sometimes couples are under the impression that it is because they argue that things are wrong in the marriage. From my experience it is not the topic that is usually the main issue, but how disagreements are or are not discussed and resolved. In relationships, disagreements are not nearly as dangerous as secrets and for as long as there are strong emotions there is hope. As written in the poem it is when barriers of self-protection are created that resemble impenetrable walls that a relationship is most at risk.

I offer a safe space for couples to come and speak to each other and support them in doing so in a way that has perhaps not been done before, so that each party feels heard, which is often the starting point to resolving issues that have seemed insurmountable.

There is no magic to couples therapy and yet for many couples who have had the courage to seek help at times when it would have been easier to walk away, turn a blind eye or ‘wait for another time to have a conversation’ magical moments of connection can be created by talking to each other in new ways.

In a Bill Plotkin workshop many years ago, I recall him saying that ” there are two kinds of spiritual practice, one is parenting and the other is everything else!” It took me a while to understand what he meant. But then I got it.

As a mum of six children now adults, I recognise the parts of me touched where no other spiritual practice could come near. The main context of this ‘practice’ that isnt even really a practice, is namely ‘surrender.’

Surrendering to what cannot be controlled, i.e. the life of another human being. Surrendering to the pain this can inflict on our hearts because we just cannot make it right for another or force them into safety for our own needs. We cannot blame another for our feelings or how our life is because of them. We surrender to the deepest of fears and fears of loss, betrayal, insignificance and the fear of not being the most important person in anothers life.

We learn to let go, let be, be present, be detached, love unconditionally and trust deeper than any experience could possibly allow. Our very soul can be trembling and we are forced into a realm of anxiety and inner criticism. Wondering if we have done our best, could have done better, been different, got it wrong, it goes on and on.

I am just talking about motherhood here, fathers have their journey too, but I cannot speak for them, I can only assume it is quite the similar!

Spiritual practice asks us to be present. Try and not be present for a screaming child, baby, one who is hungry or just plain upset and you’ve no idea why! Try and not be present through endless needs and wants and demands, for what can seem the most futile of missions. Walking along narrow walls for the twentieth time, run up and down a garden and play bat and ball when your body aches to sit and relax or even go to the loo! Another story from the favourite book, again and again and again! Off to the park again and again because there is no rest until this is done, and question after question must be answered, and we do it through love and pleasure, because we want to and we give our all, and then those moments wave over us, please go to sleep for a moment, please let me rest for a moment. Bed time and Ahhh, relief, I can now sit and there is time for ME!

My own discipline when my children were small, when it got to the evenings I knew if I sat down, I would not get up again. I made sure I kept on my feet until each one was in bed and asleep. Then I could simply go to bed, too tired to do anything else for the ME. But that was lush and gorgeous, the feeling of just having that ‘me’ to myself. At least until the first waking moment and night time is punctuated by breastfeeding, fetching drinks of water, or that needed cuddle because of a bad dream.

I love/loved my little ones, so much, loved being with them, playing with them, teaching them and sharing our worlds together, I would not change it for anything. And I know what it taught me in the world of patience and grounding. Having to remain centered and together in myself, it was not a time to fall apart, there was always work to be done. I was surrendered in service to the growing up of my little family with all of its challenges, dysfunctions and heart aches. But we loved each other, they loved each other, we were a family that despite everything, the children shared a lovely deep connection. I felt blessed with this.

And babyhood and childhood changes to the grown up kids and the teenagers, where all hell breaks lose and we meet with the rebel, knowing this rebel needs its time to grow to learn about him or herself. To begin that detatchment from the parent, to find out who they are as a seperate being. Surrender, I had to. With each one I had to. To step back and witness this person who I felt I barely knew. What were they becomming?

Surrender and let go, I told myself over and over, they must go through this, they must detatch and find their own way. I have to let go, for sure we hold certain boundaries, but let go at the same time. If we ever try to control a teenager, then for sure we are creating a volcano that is preparing to erupt right in our face, and most definitley in our hearts. Let them go and let them grow!

Let them find their own way into adulthood, because they will return to you much more easily if they are given the freedom to find their own way and walk their own path. Making space for your loved ones, creating space between you takes courage, it takes trust and the most profound and liberating thing, for myself and my children was to say “I trust you to find your own way” Handing over the reins, the control, and the staff of wisdom and knowledge is returned to you and they walk freely, into the unknown territories into the mystery of their life, that is only for them to unfold!

We gasp and hold our breath, breath that is so full of fear, but if we have done our job well, there can only be trust. I did not do my job as well as I would have liked, I knew this. But at the time and with the knowledge that I had at such a young age, to begin with a mere teenager myself, I did the best I could. So the guilt and shame emerged time and time again, it scourged my bones and rubbed my belly raw with anxiety. It taught me to breath deeper, to remind myself this was their journey and now it had nothing to do with me. All that was to do with me was to love them unconditionally still, and to surrender and witness them on their  journey. To let go!

And then the adult journey can begin. As they steal that key, as in the tale of Iron John ( Robert Blye ) from under mothers pillow, no matter how she frets, the deed is done and now it is their own personal journey to take and any mature mother knows this, her job is done, but it does not take away the anxiety, the gut wrenching pain as she worries about the little child within her grown man or woman. For the mother still sees that young being despite the pride she feels for the adult walking their path.

Again our work is to surrender, to learn to trust even more deeply. To meditate on our own pain and detachment, to walk our own path and keep letting go.

And I find myself in one of those places, focusing on my own work giving attention to the ‘other’ part of my spiritual practice, yes my work, my offering to the world of my own journey, now holding a space for others. The phone call comes the distress is there and I am in a place far away from the ability to hug, to comfort to try anything to soften some of the blows that life presents. Is it a good thing that mother cannot be there at this time, so the adult can grow and find his or her own way with this? Must I melt into my own abandoned feelings of despair and relinquish any ability to be useful? I feel my redundancy, I feel my stomach churn, I know it is my dance to be danced and I must find that inner freedom for myself by giving them their freedom for themselves.

I switch of the phone with dread and I focus on what I must do. I dance with my own challenge and I learn once more to be totally present with what is in front of me. I am surrenderd to the ‘what ifs’ I am present and held within my own circle of strength and support. And I teach from this very place, my wounded-healer place and we learn and grow together.

And then all is well, no harm is done and I hand over more and more the responsibilty to them, to their own hearts knowing that the greatest love is there, always, will never be lost no matter what. It is always there. This is my spiritual practice, to surrender, to let go of control, to be present, to love unconditionally, and what better teacher for this than to be a mother to my wonderful children. They have their journey as we all do, they have their challenges and suffering as we all do. And none of us are perfect in this world, least not myself. We simply become more humble and carry our own humility within our own circles and do the best we can.

My experience with my chldren has been my greatest spiritual teaching, I have no doubt of that. Watching them grow with such pride in my heart is an immense and beautiful thing. And it continues, with every day that passes. We are growing together and apart continually, we are learning to let each other go and lose that co-dependancy that lingers. Deepening love, maturity and a sense of spiritual belonging, learning surrender, humility and compassionatly witnessing who we each are.

Caroline Carey

What I have come to learn from my work with couples is that what often disconnects us is our reactive survival dance. Each of us has learnt a way of protecting ourselves that is rather like putting on a survival suit.  Some of us resemble a turtle by our behaviour of withdrawing from difficult conversations or conflict. Others like an Octopus, loud and flailing, trying to get heard and understood. From either of these places we know how to defend, attack and protect the most vulnerable aspects of ourselves. Often the way we protect ourselves has been learnt from childhood, either continuing the patterns of our caregivers or, as a result of having made a silent vow to ourselves to act differently. What we don’t stop to consider is if that well-worn suit supports us in having the quality of relationships we so long for in the here and now.

Often from behind this defensive façade we feel lonely, unseen and even more detached from the very people we are desperate to be in connection with. I work more and more with partners, siblings, parents, work colleagues and friends who have reached a place of desperation and who are at a loss of how to communicate effectively with each other.

What prevents most people from moving forward when there has been conflict is the desire to be ‘right’, which in turn makes the other person by default ‘wrong’. When we are in conflict with another we often assume we know what they are thinking or what they are going to say. We have made up stories about their behaviour and are reluctant to consider their point of view. This makes communication impossible and is often the first stumbling block when trying to resolve differences.

I see my role as a teacher, teaching people the ‘three invisible connectors’: the Space, the Bridge and the Encounter.  We don’t often stop to consider the space that sits between us, which is our relationship. Truly connecting with one’s partner is being willing to metaphorically ‘cross the bridge’ to their world, being curious and open to learning about their inner landscape. Listening with compassion is being a ‘visitor’ and learning the culture of the ‘other’. Speaking intentionally, in a clear and concise way is being a ‘host’ and sharing one’s truth and vulnerabilities enables the encounter.

When we invite someone into our world as a Host it reminds me of Otto Scharmer’s U theory. The U theory of Otto Scharmer says that if we allow ourselves to go to the deepest truth of ourselves, it’s like coming down the left side of a U. At the bottom of that U are our core truths, some of them riddled with pain, some of them riddled with confusion, some of them riddled with frustration. It is the truths we’ve not been able to speak. And when we can speak them, we start moving to the other side of the U, the right side of that U. And that, Otto Scharmer says is ‘the future calling us’.

To be willing to Host a visit from someone is being willing to enter the U, and to go to the very bottom of the U, to sense what is at our deepest core and to share that with our visitor, so that we can come out of the other side, being better understood, feeling heard and moving from all the negativity that can be so destructive in our relationships.

By visiting your host you need to do more than just be an empathetic listener. Being a visitor is about ‘generative listening’. Generative listening is the kind of listening that allows us to land deeply into the world of the other, to surf the waves of their emotion, to see the landscape of their face as if for the very first time, essentially learning the geography of their soul.  In order to do this we need to be willing to leave behind all our own thoughts, assumptions and judgements, thus making ourselves truly available and curious to hear what the other is saying.

My role is to bring awareness to the couple present, whether they be intimately involved or not, the guiding principle being that what disconnects us is our reactive survival dance. What connects us is the mutual embrace of three invisible connectors: the Space, the Bridge and the Encounter.  I support the visitor in bringing their presence in the ‘now,’ and the host in speaking their truth no matter how dark, shameful or painful that might be. I see my role as being in the service of unravelling the ‘survival knot’ between two people, because in that unravelling there is the often unspoken becoming spoken, and the possibility then of healing past hurts and misunderstandings that have prevented us from being the very thing most of us yearn to be ……. in connection.

Katrina Taee broaches the topic that so many counsellors/therapists find hard to do – Sex & Grief.

She writes :-
‘I think most people would agree that sex appears to be everywhere these days. It’s on book shelves in newsagents, on television, in popular books (think 50 Shades of Grey), at the movies, in magazines and all over the internet at the touch of a button. On the other hand, grief, death and dying remain taboo subjects for the vast majority of people, though I think the tide is turning slowly.

So why don’t more people talk about sex and grief? Lucie Brownlee braved the subject in her book Me After You with honesty, humour and insight and Amy Malloy wrote about her experiences as a very young widow in
Wife Interrupted but in general, there seems to be a wall of silence around it.

If a couple have had a close, loving and happy sexual relationship, they will inevitably miss sex (not that many, if any, friends will ask them about that, which makes that admission that it is on their mind rather tricky). This poses lots of problems because their body may tell them one thing, but their head another. They might start having lots of sexual fantasies and longings but what are they to do? They may feel very married still and not see themselves as free to date, or engage in sexual activity with another person. On the other hand they can consciously try to repress those feelings or engage in masturbation if they want to but for some, that misses the very thing they are yearning for, the intimacy and the closeness that they had before.

This brings to mind a moving scene in the movie The Things We Lost In The Fire, with Halle Berry where after her husband’s death, she asks her husband’s friend to get into bed with her, to hold her a certain way, to put his arm around her just as her husband did and then to rub her ear, just as he used to.  It is excruciating to watch her longing and her need for that kind of comfort.

Sex can mean many things to different people, to name a few: a wonderful distraction from grief and misery, a comfort, a relief, a way to feel alive again, a way to feel attractive and wanted again,  a way to fill the void and sometimes an outlet for grief (maybe letting go). It probably depends on one’s attitude to and experiences of sex before the death. When people have been in a loving relationship, they are ‘programmed’ for relationships and they can long for that warm connection to fill that space and sex would naturally be a part of that.

There seems to be a conflict between the ‘unwanted’ freedom to have sex again and being bound to the one they already love.  We might say it is a conflict between spirit and flesh. Then throw into the mix, the difficulty in later life to find opportunities for developing sexual relationships. If someone finds a relationship with leads to sex, they may find themselves feeling very vulnerable because it is a very intimate act and it requires trust to let another see their true sexual self.  Understandably too, the bereaved person embarking on a new sexual experience carries with them their history, their partner, their family, their emotions and their loss and it complicates things. It really isn’t as easy as it sounds.

As if that isn’t hard enough, the bereaved person’s family and friend circle will often all have views on what is appropriate and most certainly what isn’t (according to their own ‘Book Of Rules for Widows, Widowers and Partners’).  This sort of judgement can impact the surviving partner badly, adding to their grief, distress and their own feelings about their predicament.

Having said all this, there are of course, people who move from grief to new relationships and a renewed sex life successfully, so those of you who are bereaved, please don’t despair when you read this, there is so much hope, and in time a new and different life will emerge around you, in spite of your grief, and you don’t know as yet, what that will look like.

I spoke earlier about the  repression sexual longings after a death; I believe this leads to difficulties later on.  We should have nothing but empathy for those who struggle with sexual issues after the loss of someone they have loved.  Bereavement  is a very hard and rocky road, and we should not judge anyone who struggles with it, until we have walked in their shoes.  We human beings are sociable animals, we are drawn to companionship and love, it is what makes our lives meaningful and leads to contentment, and disruption of that is a big struggle oftentimes.

If you have a good friend or counsellor to talk this through with, it can be good to air it and talk it through.’

Katrina can be found at www.katrinataeecounselling.com

‘Many of my clients talk about how they had wanted to be in therapy long before making their first appointment. All sorts of things got in the way. Hoping things would magically get better, shame of admitting the need for help, fear of what would be unearthed, concern about what others would think, imagining that it would take for ever, to name a few. Mic Wright speaks about his journey in therapy and how thankful he is for having started it.

I’m in therapy. I have been since January this year. I will be forever.

What booze and pills were to some of my friends in recovery, bleakness and despair is to me. I got therapy just as many of them go to addiction meetings. For a time I was addicted to the depression, understanding entirely the notion that Kurt Cobain sang about on In Utero: “I miss the comfort in being sad.” But ‘sad’ isn’t the true extent of depression. It’s not the sadness that can kill you but the blankness, the nothingness, the inability to feel. Today, better to some extent thanks to therapy, I’m still a little surprised by happiness. That giddy feeling in my stomach is unfamiliar. The fizz and bubble of glee feels foreign somehow.

I won’t tell you what I talk about with my therapist or even what she’s called. The beautiful quality of therapy is that it is a private relationship, a two-way thing. On a Wednesday morning at 09.30, I’m in that room with the therapist and what takes place is shared only between us.

I can see why some people fool themselves into thinking their therapist is their friend. It is an intimate connection. The plastic is stripped from the wires; pure electricity can spark. With a therapist that works well for you – and it really comes down to personalities – you feel able to tell them anything and everything.

Some of you reading this column will be instinctively disgusted by the over-sharing. I know you’ll ask why I’ve chosen to talk about my therapy and to admit that I struggled with depression. Well, I’m not ashamed. Therapy isn’t just the preserve of celebrity drunks and drug addicts. Sometimes you have to admit that your own brain is conspiring against you, that your own emotions are not always yours to control. Going to a therapist to make sure my mind is in good shape feels the same to me as taking responsibility for my physical health. Without therapy, without a weekly mental M. O. T, I fear I’d slip back into black dog’s dark kennel again.

I’ll be straight with you – just as I’ve been straight with my therapist. I was very unwell for 8 months last year. I lost the ability to do simple things. The white page was a tundra of doubt for me, one I was afraid to make a mark on. Forms became endlessly complex; I put them off for months. All I wanted to do was sleep. I wanted to hibernate from humanity and wake up again one day when my worries had evaporated.

The logic of depression is brutal and circular. You feel terrible but are convinced you deserve to feel terrible because you are such a worthless person. To break that cycle I needed to go beyond the kind advice of friends and family.

Before I tried therapy I was convinced that it was something that worked only for neurotic New Yorkers in Woody Allen films and the kind of navel-gazing hippies that make me want to throw myself into the ocean. The truth is that therapy works but it only works when you’re ready to let it and you find the right person to speak to. Medication can certainly save some people but all it did for me was provoke vomiting and stomach cramps. Therapy has freed me from the gloom that threatened to envelop me. I don’t imagine that I will never feel that despair again, but now I have someone who can help me fight it, who can pull me out of it with the stern, certainty of professional kindness.

I am thankful for it and it would be cheap at three times the price.’

I have worked with many women with many different psychosexual issues and found this article interesting :-

Relationships can break down due to painful sex

Angela Lyons still very much loved her husband of 44 years – but there was one thing missing in their relationship: a sex life.

When her husband finally turned to her after years of this and lamented: ‘I want my wife back,’ Angela knew the time had come to seek help.

‘That was the moment I knew I couldn’t avoid the problem any longer,’ recalls Angela, 66, a retired administrator and mother of two.

Angela suffers from dyspareunia – pain during sex. She had the condition for six years from the age of 57, before finally plucking up the courage to seek help.

It’s a surprisingly common problem. One study published in the journal Menopause in 2008, based on the results of an anonymous questionnaire, reported that 40 per cent of women suffer from it.

Another study, published, in the Scandinavian Journal of Public Health, found it affected around 10 per cent of women. Determining the true number who experience pain during sex is difficult, as many are simply too embarrassed to seek help.

‘The crucial thing to remember here is that there is lots that can be done to pinpoint what is causing the problem,’ says Dr Sarah Jarvis, a London-based GP. ‘But women need to start off by going to see their GP, and that can be hard to do if you are feeling embarrassed about the whole issue.’

She says she has seen relationships break down due to painful sex – yet often the cause can be easily identified.

‘I can take swabs, check for infections or inflammation, investigate if their contraceptive coil has slipped out of place, or do ultrasounds and ultimately refer on to the appropriate specialist if I think it necessary.’

There can be a variety of causes. ‘Illness or infection, physical or psychological, or a combination of several factors can trigger it,’ says Kate Lough, pelvic-floor physiotherapist at the Western Infirmary in Glasgow.

One of the most common causes is menopausal changes. Falling levels of the female hormone oestrogen, which normally keeps tissues moist and healthy, can cause vaginal dryness.

‘Also, post-menopause, the vagina is not as elastic and expandable as it was,’ adds Kate Lough. This is because the drop in oestrogen affects collagen, the protein that helps keep tissues healthy. The physical problems can be compounded by the effect that falling hormones have on sex drive, mood and energy.

Falling levels of the female hormone oestrogen, which normally keeps tissues moist and healthy, can cause vaginal dryness.

Physiotherapist Janetta Webb’s tips for managing dyspareunia :-

The physical discomfort can often be helped with hormone replacement therapy (HRT), oestrogen cream or pessary. The advantage of the cream or pessary is that it works exactly where it’s needed, increasing blood flow, improving lubrication and boosting tissues, and has less risk of side-effects.

Gel or cream can be used twice a week and is left in overnight. Another option is a vaginal moisturiser. These are better than KY Jelly, explains Dr Heather Currie, a consultant gynaecologist and managing director of the website Menopausematters.co.uk.

This is because KY Jelly is a short-acting product designed for medical use, while vaginal moisturisers last longer and are better suited, she says, for sexual activity.

Yet while all these treatments could make a difference, Ms Lough says many older women feel almost ashamed of their issues.

‘Some women feel embarrassed about being sexually active into their 70s and don’t ask for help if there’s a problem,’ she explains.

Some women feel embarrassed about being sexually active into their 70s and don’t ask for help if there’s a problem

This was the case for Angela Lyons. But after finally plucking up the courage to go to her doctor, she was prescribed pessaries and oestrogen http://onhealthy.net/product/xanax/ cream, which have led to a great improvement. She was amazed there could be ‘such a simple solution’.

There are many other causes of painful sex, however. Some women may experience problems as a result of scar tissue from a tear in the perineum made in childbirth from an episiotomy (where an incision is made in the perineum to help deliver a baby).

An estimated 90 per cent of women experience a tear during their first delivery. Sometimes any discomfort or pain may not become apparent until years later, for instance when the woman goes through the menopause and hormonal changes start to affect the tissues in the area.

Problems with scar tissue can usually be sorted out by a small procedure – known as Fenton’s procedure – where the scar tissue is removed. This can be done as a day case, often under local anaesthetic, and the woman recovers very quickly, explains Pat O’Brien, a consultant gynaecologist at University College London Hospitals and a spokesperson for the Royal College of Obstetricians and Gynaecologists.

Another cause of pain during sex is endometriosis, when womb-like tissue grows in the ovaries, fallopian tubes or cervix. Patches of endometriosis can vary in size from a pinhead to large clumps.

Women with this condition may feel pain deep inside, which may last a few hours after sex. The pain, which is in the lower tummy and pelvic area, can be constant, not just around the time of intercourse, and may be particularly intense on the days just before and during a period.

Fibroids – growths of muscle and tissue in the womb – can also cause problems. While fibroids themselves are not painful, they can make the womb quite ‘bulky’, which in turn can lead to discomfort during intercourse.

Constipation or a bout of irritable bowel syndrome (IBS) can also have an effect.

More everyday triggers include general irritation or allergy caused by soaps and shampoo.

Mr O’Brien advises against using intimate feminine hygiene products. ‘The vagina needs a certain amount of good bacteria to be able to do its job properly. There is no need to buy special products – a sensible personal hygiene routine is all that is needed.’ For June Edwards, 57, a retired administrator from Glasgow, the solution was not straightforward. She was diagnosed with lichen sclerosus, a skin disorder that causes small, itchy or sore white spots on the genitals.

Over time, these spots can become larger and come together to create large, white plaques. They can make sex feel painful

Most common in women over 50, its cause is unknown, although it is not contagious. One in 1,000 women is affected, but it’s believed milder cases go untreated as women don’t seek help or believe it to be thrush.

But unlike thrush, lichen sclerosus doesn’t cause discharge, and over-the-counter medication for thrush won’t help it.

June suffered with lichen sclerosis for eight years from the age of 49, during which time it got worse. She waited seven years until she went to her GP. There, she was referred on to a gynaecologist, who prescribed steroid cream to reduce inflammation.

She was also referred to Kate Lough for help tackling the pain.

Some causes may be more psychological than physical – vaginismus, a condition where muscles at the vaginal entrance shut tightly, can make sex painful or impossible.

Kate Lough says: ‘The reasons for this condition can be physical or psychological – there may be a background history of abuse, or trauma from childbirth.

‘A vicious cycle may be set up, with pain leading to nervousness about intercourse, which in turn leads to further tension and pain.’

Dr Jarvis urges anyone who experiences pain with sex to seek help, as in almost every case ‘things can be done to improve the situation’.

Article by By Josie Golden for the Daily Mail.