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20th March 2018 

The shame paradox: how speaking shame can transform it. March 2018

If there is one emotion that I can pretty much guarantee will come through the door with a new client, it is shame. And it is usually the last emotion to arrive. We will work through grief, make space for the expression of anger, gently probe at sadness, and, finally, if all is going well in the work, like the kernel in the nut, we will arrive at shame.

So why is it always there, and why is it so hard to talk about? The renowned shame researcher, Brene Brown, argues that shame is a universal emotion: we all experience it. But, she says, it is the hardest emotion to talk about: "shame is so powerful that we sometimes feel shame just by talking about shame".

I was thinking about shame as I was doing an interview for a book project I am working on on being childless-by-circumstance. (That is when you would like to have a child, and believe yourself to be biologically fertile, but because of the circumstances of your life, that has not happened, or has not happened yet.) I was talking to the author, Tessa Broad, who wrote a moving account of her attempts to have children in her book: "Dear You: A letter to my unborn children", and she talked about her childlessness as feeling like she had "a dark, shameful secret".

This made sense to me as I had written my MA thesis on circumstantially childless women, and how they experienced psychotherapy, and what I discovered was that my participants didn't really experience their circumstantial childlessness in psychotherapy - because they didn't talk about it. One of them said she didn't raise it with her therapist because she was too ashamed.

I was blown away by this discovery. Here was this enormous life experience - not having children when you wanted them -- which now affects 1 in 5 women who have reached the age of 45 and my research participants found it so hard to talk about, they couldn't even bring it up in the therapy room. I realised that shame - and the social taboo around involuntary childlessness -- had the effect of silencing many women who do not have children.

In the light of my research findings, I decided to specialise in working with this group of women in my psychotherapy practice and so a number of these childless women -- along with a few childless men -- find their way into my consulting room. They are aged from their mid 30s upwards and want to have children, but for one reason or another due to the vagaries of their lives it is not happening - and they fear it will not. Underneath the layers of anxiety about time running out, and grief at failed relationships, I sense there is often a barely articulated question: is there something wrong with me?

This is the pulsing heart of shame: the sense that we are in some way at fault. It eats away inside us, making us feel as if we have in some way failed, that we have uniquely screwed up our lives. It is a noxious, undermining, consuming and devastating emotion that ends up making people feel isolated and alone. Brown defines it like this: "shame is the intensely painful feeling or experience of believing we are flawed and therefore unworthy of acceptance or belonging".

Rather than mollify these feelings, society magnifies them. Unlike biological infertility, dealing with a failed relationship, and the dashed hopes of having a child, in your late 30s and 40s, are not socially recognised. There are no words of comfort directed at the 40-year-old woman who thought that she was on the road to becoming a mother when her boyfriend walks out: no public recognition of the scale of that loss. Instead, many women I have spoken to for this book project report that if they dare to discuss their sense of loss, they were met with comments like: "You shouldn't be so picky about men." "You could always adopt." "Have you had your eggs frozen?". There is a feeling of being outcast, of being on the outside of society

It is any wonder then that against this social backdrop, buried beneath all of this, when you are scrambling to find a partner and settle down, and conceive, in the decade long window of waning fertility from 35 to 45, there is a sense of shame?

Like every other emotion that enters the therapy room, the first step is to identify its existence. And, in the case of shame, that's hard, because it tends to lurk in the shadows of our mind, where it unconsciously drives thoughts, feelings and behaviours. Such is the power of its pain, many of us avoid acknowledging that we experience it at all. In her seminal work on shame, "I thought it was just me (but it isn't)," Brown talks about the importance of recognising our shame triggers.

We can only transform our shame and vulnerability when we are able to give it words, and to be able to do that, Brown argues, we need to accept that acknowledging our vulnerabilities is an act of courage. When we can feel the visceral, pulsing discomfort of shame, and label it as shame, we are in a position to express it, process and manage it. Before then, we tend to stuff it down inside ourselves where it festers, leaking out as doubts about the value of our very existence.

Once we become adept at labelling our shame triggers, we can also begin, as Brown explains, to put it into critical perspective. Like a camera lens, when we are focused on our shame, it is zoomed in on ourselves, but if we begin to zoom out, we begin to see that we are not the only ones. So it is with circumstantial childlessness. 1 in 5 women hitting 45 without children equates to 1.5 million women, and that doesn't include the 1 million or so women who are 35 + and are childless. Once you begin to see it like that, you begin to realise there is a whole tribe out there.

It also helps to understand why. Jody, Day whose brilliant book, "Living the Life Unexpected" has done so much to give voice to childless women, talks about this generation as the "shock absorbers for the sexual revolution": women who were often brought up to go into tertiary education, pursue a career, and find a partner, and then expected to conceive all before the age of 35. On top of which, there appears to be a shortage of "high-status" men for these women to marry. We realise that we are dealing with a social phenomenon, not a personal failing.

This is important because the power of shame lies in remaining undetected: it seeks silence and secrecy - Broad's "dark, shameful secret". In writing her book, Broad, in an act of courage, reached out and shared her story of battling to have children and then ending up without them, with the world. She told me that she felt lighter afterwards: "I did have this feeling that at last people got me and that felt rather nice". The act of writing it and exposing her vulnerability acted as a powerful antidote to the secrecy of shame.

This is speaking shame: and Brown argues that if we really want to change our relationship with shame, then we must learn to speak shame. There is, of course, a risk inherent in this, a risk that we will be judged or shut down. But Brown argues that it is worth the risk. When we speak shame, and we feel heard and supported, we transform our experience of shame. We no longer feel isolated and alone, we feel we belong. In my work, I try to help clients find words to express the squirming, excruciating feelings of shame, and share them - to tell their own stories -- so that they can go from thinking is there something wrong with me? to knowing that there is not.

Should therapists tell their story? February 2018

One of the conundrums that all psychotherapists face is how much of themselves to reveal. We have most of us seen the Hollywood image of the po-faced psychoanalyst who sits stiff-backed in a chair, occasionally uttering Ah-has and the odd piercing insight, as the patient unburdens themselves of their deepest fears.

A few psychoanalysts may practice like this nowadays, but for the most part this level of detachment went out of fashion in psychotherapy with the advent of the television. Nowadays, it is all about the relationship.

And, with the relationship at the centre of the practice, it opens up the question: who is the client relating too?

It is a question that I wrestle with frequently in the therapy room. How much of myself should I bring into the room? But I was particularly struck by the question when I was doing some filming with my accrediting body, the United Kingdom Council for Psychotherapy, a couple of weeks ago, and they asked me: what brought you into psychotherapy?

I ummed and aahed about how to answer this question because doing so would reveal an aspect of myself that I have not brought into my psychotherapy practice before. I had to ask myself: why had I not written or spoken about it in public? Was I keeping quiet to protect my clients, or was I keep quiet to protect myself? Over coffee with a fellow psychotherapist, we pondered this question. He too wrestles with how much of himself to bring to the therapeutic encounter, and he suggested that perhaps the question should be: is revealing something about yourself going to benefit the client?

The traditional reason for the psychotherapist to appear as a blank slate is rooted in the thinking of the grandfather of psychotherapy, Sigmund Freud. He came up with the concept of transference, which is, essentially, that each of us has ways of relating to people, which we learn as children in our interactions with our parents, and which, as we grow up, we continue to project on to other people. If the therapist is a clean slate, the thinking goes, we can see those projections more clearly: like a film being projected on a screen.

If, on the other hand, the client knows too much about us as therapists, we can no longer see that film projection so clearly: it gets twisted and distorted. Therefore, therapists believe, if you want to work with the transference, you have to stay behind the screen. There are also other more practical reasons for staying quiet about yourself as therapist: you the client, after all, are paying to talk about your own struggles and challenges, not those of the therapist you are sitting with.

But, as I was preparing for my interview with the UKCP, I got thinking about the power of story-telling. It seems that the not-so-secret ingredient in the story of every successful motivational speaker is that they themselves made the journey from the darkness of a terrible illness or misfortune into the light of healing. There is something powerfully moving about the story of transformation: it can inspire, it can motivate, and it can make the listener feel as if they are not alone in their own life’s journey.

What it does, I realised, is give voice to that universal feeling of vulnerability. It brings the shame that someone may feel at their own struggles, and transforms it by bringing it into the open, where it can be shared and met with understanding and empathy. It is a public display of what goes on behind closed doors in the therapy room.

So I decided that to talk about my own experience with depression and anxiety on film might be of benefit to my, and other peoples, clients. It might help clients to know that I as a therapist, like anyone, am very human, that I have vulnerabilities and struggles of my own. In doing so, it might also lesson the power imbalance that might occur in the therapy room, when one person doing the relating is desperately struggling and the other seems, on the face of it, to be sorted.

In the interview, I described how at the age of 23 I sank into a spell of depression, mixed with crippling anxiety. I was living in Russia at the time, and self-medicating with vodka and Russian Champanski. I finally made it back to London, and remember sitting crouched in the foetal position in a chair, describing to a patient and kind psychotherapist that I was going mad. I will always remember her words to me: “You are not mad, you are sad”.

And, indeed, I was sad. Desperately sad. I was grieving the loss of someone very close to me, and I did not have a clue how to do that. This psychotherapist taught me a whole new vocabulary of emotions, that I had not learnt as a child. And, as a result, of being able to name my feelings, I was then able to express and process them. As she opened this technicolour world of emotions up to me in her warm and empathic manner, I remember thinking to myself: “I want to be you when I grow up”.

It was not the last bout of depression and anxiety I have had, but each time I have turned to therapy as a way of identifying the emotions that underlie the illness: each time, I learn more about that emotional vocabulary and how to express it. Twenty years on from my first therapy, I began to train as a psychotherapist myself, and my first’s therapist words, and her way of being so present and so empathic, are a profound influence on me, and how I try to be with my clients.

Ultimately, therapy is not the place to say to your clients: I feel your pain, I have been there too. Everybody’s pain is different, and it is the therapist’s job to help the client explore their own inner turmoil. But, sometimes, I have come to the conclusion that it can benefit clients to know that we all have our struggles on this human journey of life – and therapists are no different to anybody else.

You're a psychotherapist: what is it you actually do? January 2018

One question that I get asked a lot as a psychotherapist, is: what is it that you actually do? What on earth goes on in psychotherapy?

In fact, I got asked this very same question last week, as I was doing some filming for my accrediting body, the not-so-snappily titled, United Kingdom Council for Psychotherapists, who are trying to demystify the world of psychotherapy for those who are perplexed by what it is and what it actually does.

In the course of answering these questions, I had to do some hard thinking to work out how to condense over a century of thinking and research into the mind, and how to heal it, and neatly package it up in a few soundbites.

The truth is there is no single right way to answer the question what goes on in psychotherapy – every psychotherapist will have their own way of explaining what it is they do. But perhaps one thing that most psychotherapists would agree on is that, on the surface of it, psychotherapy is a talking therapy. It uses language to explore states of minds, and feelings. But, as I thought about it in preparation for the filming, I realised that for me as a psychotherapist, talking may be the tool that we as the participants use, but that at the heart of psychotherapy is the relationship.

It is this relationship that forms the bedrock of the journey that both client and therapist make in a quest to help you, as the client, experience healing and greater wholeness. I believe that when you enter therapy you as the client becomes an emotional adventurer, uncovering terrain that you may have been cut off from or unable to venture into, for years. And I, as the therapist, have the privilege and honour to accompany you as a guide and an ally.

From the very first consultation call through the weeks and months we work together, we embark on an alliance that allows us to be joint explorers of the inner reaches of your psyche and your soul, unearthing your deepest fears and desires, and exploring your dreams, your pain, and your shame. When that alliance works, it creates a spirit of open curiosity and compassion, that allows you as the client to venture to the places inside you that may have felt too dark, difficult and dispiriting to venture to alone.

It can be a journey that at the start heads in one direction, but then leads us into unexpected twists and turns. Each of these meanderings can be useful lessons, that help to illuminate your beliefs and feelings, and help us on the road to enabling you to find understanding and consciousness. What is crucial is that the exploration happens with the therapist by your side in the safe and therapeutic container of the therapy room.

I believe that this is where the real therapy lies: in the relationship between client and therapist as we undergo this journey together. In my psychotherapy studies I learnt that our patterns, beliefs and conditioning are encoded in us as children through our relationships with those around us, so it is only in the cauldron of a reparative relationship that these patterns can be understood, and that they can be healed and transformed.

I like to think of it like a computer programme. We are programmed one way as children, by the experiences of our early relationships, and we can live our lives according to those out-dated algorithms. Or, in therapy, we can find a way to update that programming by rerunning the programme in a new context, a healing and transformative relationship with a therapist who is warm, empathic and present.

On this journey, it’s important to remember that I, the therapist, am not the expert on you. I can not know what goes on in the deepest reaches of your psyche, until you use language to bring those thoughts and feelings into the therapy room. You are the expert on you. As the therapist, I am trained to help you to get more in touch with you, and to help you to find the awareness and tools that you need along the way.

The journey of therapy is many things: it can help you gain a new understanding of yourself, it can help you learn new skills and behaviours that you can employ in the therapy room and in your life beyond. But, at its heart, I believe it is a profoundly special type of relationship that can help you re-experience yourself and your life’s story in a deeply transformative way that can heal your wounds, and can stay with you for the rest of your life.

If you are interested in setting off on such a journey, I invite you to contact me to explore how we can work together at this time.