“And the day came when the risk to remain tight in a bud was more painful than the risk it took to blossom.”
Anaïs Nin AUTHOR, DIARIST
Dedicated to the Treatment of Adult and Adolescent Mental Health, Complex and Developmental Trauma, Perinatal Wellbeing, and Personality Difficulties
Everybody has experiences of rational fear, worry and helplessness which may be momentary, or sustained during periods of stress. Clinical anxiety is generally more pervasive, overwhelming, debilitating and impairing a person’s ability to achieve in work, love and life.
The experience of anxiety is inherently unique, despite some commonalities of sensations and emotions. Anxiety is frequently experienced as worry and concern, or nervousness. For some people, it presents as sudden panic attacks, which seem to come “out of the blue”, with intense somatic reactions such as dizziness, trembling, increased heart rate, nausea, difficulties with sleep, concentration and fatigue. For yet others, anxiety may be experienced as social phobia, or fear of negative evaluations from others, perfectionism, fear of making mistakes, or loss of a sense of control. The source and causes of the anxiety is often unclear, which makes it a very distressing experience, as there is no clear danger to defend against, or escape from.
While many people choose to look to pharmaceutical tranquillisers to assist them to manage anxiety, psychotherapy has a radically different view. In therapy, anxiety is seen as an important psychological and physical experience which can be understood if allowed to be explored. In time and with examination in a therapeutic relationship, the underlying basis of anxiety can be illuminated and worked through.
Therefore, in treatment, anxiety may be viewed as a signpost to direct patient and therapist towards an area of life that needs to be explored and potentially altered.
Depression – feelings of pervasive sorrow, dejection and unremitting downheartedness affects as many as one in six women, and one in eight men in Australia at some point in their lives. For some people, there are clear events which precede a depressive episode, such as loss (such as loss of a job, finances, partner or social position), separation, a serious medical illness, or worsening drug and alcohol use. For others, it may not be as clear as to how or why a depressive period emerged, and in these cases, depression is sometimes linked to earlier life experiences which may be unprocessed and unacknowledged.
When people explore their experiences of depression, they commonly report feeling guilty, overwhelmed and sad, withdrawing from social activities, difficulty completing work or school tasks, inability to concentrate, feeling overwhelmed, irritable, lacking in pleasure and confidence, fatigue, loss of sexual desire, and suicidal thoughts.
Many people seek help from pharmaceutical medication or “positive thinking” approaches to manage depressive symptoms. While for many people such treatments may be beneficial, they also deal with the surface level of issues. Often, people further benefit from a psychodynamic approach to treating depression. In this way of working, depressive symptoms are viewed as important signposts and invitations to explore a person’s experiences and situations preceding the difficulties. This form of therapy invites people to consider with honesty and self-reflection values, motivations and beliefs which may be indirectly contributing to pervasive feelings of distress.
Perinatal Wellbeing and Parenting
Becoming a parent is an important developmental milestone and a major life and role transition. Although this is a time of celebration, for many parents this also presents unforeseen struggles and challenges which can be overwhelming. Depression and anxiety are very common in the perinatal period (during pregnancy, and up to the first 12 months following childbirth). As many as 1 in 7 new mums, and 1 in 10 new dads report symptoms consistent with depression and anxiety. Parents with such difficulties often report difficulty finding enjoyment, pervasive feelings of sadness or intense irritability, sleeping difficulties, restlessness, fatigue, and difficulty thinking clearly.
Parents with preschool, primary school and high-school aged children also require a great amount of adaptability. Older children are constantly growing and changing, and this may place demands on parents which may be difficult to manage if they have not had adequate support themselves. It may also be a time when attachment issues related to their own experiences of being parented may be brought to the surface.
Therapy may be of assistance as parents adapt to the demands of parenthood. With support, many parents are able to adjust to the impact that parenting challenges present. Choosing a therapeutic space allows parents the time to tune into their own needs and process difficulties arising within an empathic and non-judgmental relationship.
Melanie is a registered Circle of Security parent reflection program facilitator. The program explores parent/child interactions, healthy options in care giving, and attuning to children's needs to develop secure attachments. Melanie convenes parent groups or individual sessions for those wanting to make sense of their child's needs, consider the ways they may wish to parent differently from their own experiences of being parented, and develop a secure attachment with their children.
Many individuals come to therapy because they are struggling in the aftermath of experiencing overwhelming stress. Such people have experienced or witnessed life-threatening events, or events which were extremely frightening. Such experiences commonly include natural disasters, accidents, being the victim of violence or crime, betrayal in interpersonal relationships, and different forms of emotional, verbal, physical and sexual abuse. It is understandable that trauma makes it difficult for a person to understand, make meaning of, and integrate experiences into their worldview. People who experienced abuse early in life may be especially impacted. Early trauma occurs at a vulnerable period where verbal, emotional, and cognitive centres are still developing. This is especially so when trauma has occured at the hands of those who were entrusted with their care and protection.
It is common for those who have experienced ongoing exposure to trauma to have memory and concentration difficulties, difficulties trusting others, and pervasive experiences of anxiety. Shame and guilt are also often experienced, and a person may blame themselves for the trauma or abuse, which may lead to a sense of helplessness in moving beyond the fear of he original traumatic experience.
Therapy assists those impacted by trauma by exploring the broader life context, values and sense of self, and experiences of betrayal, manipulation and confusion of the person. Exploring in this way with another person is helpful in gradually giving words to somatic and emotional experiences which were previously unexplored. This form of therapy can help individuals to bring meaning and understanding to traumatic experiences, situating these within their broader life and relationships.
For those people struggling with the daily reality of living with a personality disorder, it can feel difficult to find help. People with a personality disorder describe overwhelming feelings of loneliness, anger, shame and resentment. Such intense feelings tend to impact the ability to develop and maintain meaningful relationships with others.
Through engagement in psychotherapy, many individuals are able to work towards improvement in self-understanding. Talking with a therapist provides a different attachment experience than many individuals may have previously experienced. The therapist is a neutral person who can provide emotional support and can bring understanding about the origins of personality difficulties, rather than giving advice and things to do. The opportunity to explore and express one's emotions, inner thoughts and sense of self with another person, while building understanding that others can have different conceptualisations from ones' own, can help people to improve their ability to manage challenging emotions. Over time, this work can be transformative for other relationships in life.
Hopelessness, Confusion, Problematic Patterns of Behaviour
Some people decide to speak to a therapist about worries and difficulties that are not the result of a life crisis or trauma. The decision to seek therapy might come about as a desire to learn more about oneself, to bring meaning to one's ideas, values, and desires, and to liberate oneself from problemmatic behaviours which repeat in one's life. Other people are looking for a way to better tolerate distressing feelings and bring meaning to confusing emotions.
While there are many psychological therapies which offer self-improvement techniques, advice, and behavioural strategies, psychodynamic psychotherapy provides a safe and confidential space where individuals can explore their thoughts, feelings and desires freely, openly, and without judgement. While some people find their own way of answering existential questions related to their own patterns to find meaning and direction for their life, therapy can be of assistance to bring about transformative effects as understanding, meaning, and hope is generated.