Anxiety -Symposium -BCAT

Saturday, March 20th 2021 – Classroom or Zoom (tbc*)

Anxiety with Smita Rajput Kamble

Anxiety affects daily life. Development and growth is that rare human achievement when we can overcome anxiety and it’s debilitating affects. This symposium will get to grips with understanding anxiety via a psychodynamic lens.

WHEN: Saturday 20th March, 2021 – 10am to 1 pm (with breaks).

WHERE: The Gateway Building, University of Bedfordshire, Polhill Avenue, Bedford, MK41 9EA (tbc*)

COST: £75 (£65 students).

Payment:

You can pay by direct bank transfer to Coop Bank, sort code 089299, account no. 65682890, putting your own name as a reference and email us to say you have done this, or send a cheque payable to Bedford Counselling Centre to Bedford Counselling and Training, 71 Gwyn Street, Bedfordshire MK40 1HH.

Why do this workshop?
We experience anxiety and fear every day of our lives-whether it is about work, our health and safety and/or our relationships with others. Anxiety and generalised anxiety disorder almost always tops the chart of most browsed mental health subjects. This symposium will give you an in depth understanding of anxiety and its roots in guilt, hate and fear of castration. In the therapeutic space of group and individual work you will be able to understand how you as a practitioner help people manage their anxiety and begin to heal.

Aims

  1. To understand what is anxiety –its function in normal and abnormal conditions. The effect of fear and anxiety on possibilities of growth and development.
  2. The psychodynamic lens: pre-oedipal and oedipal anxiety. Klein and Freud on anxiety.
  3. To discuss how and why we help clients become less anxious and more contained.

Process for symposium

There will be a speaker presentation on the history of and psychodynamic theories about anxiety as well as examples of its presentation in the consulting room. The presentation will be followed by participant discussion. The speaker will then

facilitate pair and group work so that participants can apply theory to their own clinical practice examples.

Target Audience

This symposium is suitable for qualified and training psychodynamic psychotherapists, counsellors and mental health practitioners. The primary theoretical focus will be psychodynamic, but practitioners of other modalities are welcome to attend as long as they have made themselves familiar with some of the pre-course reading.

Smita Rajput Kamble 

Smita is a psychoanalytic psychotherapist in private practice. She is a training supervisor at Bedford Counselling

Foundation. In the past, she was one of the faculty at WPF Therapy, London Bridge where she taught the Advanced Clinical and Theoretical Issues seminar to Year 3 and 4 psychodynamic psychotherapy trainees. She also conducts CPD activities within the psychodynamic community in London.

*Please note that this symposium may either be held at the University of Bedfordshire in Bedford or on Zoom, depending on the state of Covid 19 restrictions by March.


CONTACT US TODAY TO BOOK A PLACE:
TEL: 01234 219905 – EMAIL: enquiries@bcat-team.org.uk
Please email us if you are interested in receiving up to date information about our CPD programme, courses and conference and we will add you to our mailing list.

Meditative Method

Like a water lily, grounded, looking upwards

Meditative methods are as numerous as there are beliefs and approaches in this world. Most of them will expect that you can still yourself and concentrate on something to calm yourself. If this works for you-concentrating perhaps on a ray of light, or white light or a point on your forehead etc, start this way. Starting any way possible is a good step forward. Meditation has too many known benefits. Hypertension and many other diseases are known to become less problematic-blood pressure and heart rate fall considerably with meditation. Once you have learned to marshall/collect your thoughts, then try the method below:

The best method is to let thoughts pass by, without judging them. You are only an observer. You do not have to act on them. You can say to yourself ‘this is my thought’ but you don’t react. These thoughts might be alarming, disgusting, upsetting…triggering action…it does not matter. They must pass by like an assembly line – where you watch them but don’t exercise restraint or do anything to change them. After some time, gaps will occur. Like the glimpse of sky between clouds. A time will pass and there is no thought. These gaps are restful, the result of lack of judgment and manic pursuing of thoughts. It is the free space in which you will feel liberated, timeless. Savour the gaps. Enjoy them. They will pass and other thoughts will come – things to do, jobs to get back to.

Let thoughts come in now. It is alright now to go back. You have meditated, even if it is for a minute. You will not have to force yourself to make meditation a part of your routine anymore. Your body will like to go to that place again. You can do it anytime, anywhere. It will be an enjoyable restful activity.

At times, you may fall asleep. Some views suggest that it is not meditation of you fall asleep. I say that anything that helps you to go into a deep sleep is a good thing. Clearly, your mind and body needed it !

What is Trauma and How We Try to Master It


In one of his earliest essays, Beyond the Pleasure Principle (1920), Sigmund Freud discusses the case of a boy, one and a half years old, who develops a game to deal with the trauma that he suffers for the first time when his mother, who he is very attached to, goes away for a prolonged visit and then returns.

He throws the ball over the bed and it goes out of sight. He makes a sound to show his surprise and wonder. After it is found and brought to him, he does an ‘ooo…’ in a delighted way.

Freud is promoting the theory that there is an economic motive involved-the need to restore ‘pleasure’ by which Freud means ‘equilibrium’ in the psychical system which has endured a sudden shock of not seeing his mother for an unpredictable time.

Sigmund Freud

This is how the game helps him to master the trauma of seperation and loss. Says Freud: “..At the outset, he (the boy) was in a passive situation-he was overpowered by the experience; but by repeating it, unpleasurable though it was, as a game, he took on the active part.” 

This observation -deduction has paved the way for the development of the idea of trauma. Not many credit Freud anymore. With new approaches, the original thinker is ‘deleted’. Do read his works. Elegant writer.

From this game, he also deduced that an object thrown away by this child is his/her way of mastering his anger, owning it. If you can imagine that the object/toy stands for mother or father or anyone who he/she is attached to and leaves unexpectedly, causing uncertainty and pain, a child can at least take it out on the object/toy and throw it away or break it. This little boy had heard that his father had to ‘go away to the front’ as it was war time. He would throw the object away and say, ‘go to the fwont!’ In this way, he was able to master, at least in his mind, a situation he had no control over-his father going to war, his mother leaving him for a visit.

Why is Meditation Difficult ?

Meditation is a part of the concept of mindfulness. Being present and moving from reaction to reflection. 

People have trouble meditating because we are so programmed to structure our thinking through various routines, it is difficult to try something unstructured which feels empty. 

For e.g, if your day is filled with activities it makes you feel you have achieved something – jobs are ticked and done. In this case, meditation becomes another activity to be ticked. What it ought to be is a timelessness-a space where you don’t realise how much time has passed and that you actually did tick a box !

Our minds are hardworking spaces- constantly taking in and processing stimuli from the environment. Meditation is the only way you can rest it, besides sleep of course. Even in sleep, the mind processes difficult emotions which can result in dreams. These dreams when interpreted, can create a way of living which is very satisfying.

Meditation is an unstructured space. An unstructured space is prone to get cluttered up – a bit like the garden shed. Unwanted thoughts, judgments, musings…..these create anxiety and the person finds meditating difficult. If you find yourself forcing a calmness, it is counterproductive. You ought not to be forcing a calm.

Is your Therapist Mindful?

According to the Wiki, ‘Mindfulness plays a central role in the teaching of Buddhist meditation …described as a calm awareness of one’s body functions, feelings, content of consciousness, or consciousness itself, it is the seventh element of the Noble Eightfold Path, the practice of which supports analysis resulting in the development of wisdom. The Satipatthana Sutta (Sanskrit) is one of the foremost early texts dealing with mindfulness. A key innovative teaching of the Buddha was that meditative stabilisation must be combined with liberating discernment.

Mindfulness practice, inherited from the Buddhist tradition, is increasingly being employed in Western psychology to alleviate a variety of mental and physical conditions, including obsessive-compulsive disorder and anxiety and in the prevention of relapse in depression and drug addiction.’

How does a therapist incorporate mindfulness?

‘Congruence’ and ‘countertransference’ are concepts that come close to a natural and organic incorporation of mindfulness. Through an inner knowledge of himself/herself and how one is feeling with the client in the present moment, a therapist is able to help the client process difficult feelings in the room.

How does a person incorporate mindfulness in everyday life?

A quiet spot in a busy day is enough to become aware of one’s feelings, who/what triggered them and letting go of their clinging negative properties, like allowing a ship to let go off the harbour. Mindfulness is the important punctuation needed to move from reaction to reflection. Reactions are lively, reflections are calming.

However, sometimes a deeper exploration cannot be embarked on when there is a crisis and life becomes a set of reactions. At such times, an effort at reflecting may stop a spiral of destructive reactions.

What is Psychotherapy ?

Psychotherapy is a process. If you can believe that all living organisms require a cocoon in order to transform into something else, then therapy can be that cocoon. You sit week to week with a psychotherapist who knows what the process is and listens attentively. You pay for it so the process is marked as something that needs to have some achievable results.

Jung wrote extensively of the process of individuation and rebirth. He urged getting rid of moralising and seeing every action as part of a process.  Moralising tends to keep one in a simple, one dimensional compass-it reduces creative ways of thinking about problems.

For e.g, if your spouse cheated on you, you would go into some reactive mode – leave or make charges, file for divorce etc.

On the other hand, you could ask ‘why now?’ which may lead to a better understanding of how someone may have reacted :

  1. for eg, was it the onset of midlife (starting from mid 20s) or
  2. The coming of age of children, the uncomfortable feelings they arouse and the displacement of such feelings onto an outsider.
  3. It could lead to an understanding of how the person’s parents behaved at a similar time-
  4. in a family that lives together, more often than not, we pick up behaviour that is embedded deeply rather than the ‘we must not do this and that’ which we constantly repeat to ourselves.

If my son for eg breaks a plate, the doorbell is ringing and I find out I have lost my wallet I am more likely to behave like my parents than all the taught behaviour of how I must react because the crisis disbands studied ways of thinking. It takes us back to our primitive roots.

Psychotherapy that can bring about change, that punctuation in your attitudes and behaviour if you allow it to.

Fathers and their function ..

Traditionally, the father went out into the world and brought back the sustenance from the outside world that the family require-food, shelter, warmth. In ancient times, still visible in more primitive places, he deals with the threats from the external world and interrupts the mother-child duo with, ‘I too belong with you’. this would the classical view, as proposed by psychodynamic literature from the past.

From the beginning of time, mother has played this part too. Fathers have gone to battle and mothers have gone into the wild for foraging and guarding the home and vice versa, mothers have left it to the fathers to do the mothering. This shows us that the gender of a person does not necessarily align with maternal and paternal, masculine and feminine, from the beginning of civilisation.

In psychodynamic thinking, fathers are symbolically associated with rules and regulations – the boundaries that keep a child safe not only from the external world but the internal one. This may take away from empathy and the more maternal aspect of nurturing so that the role of a father-whether a woman or man does it- may be seen as hard, someone who comes in the way of freedom to do as we please.

Mothers clearly do this job many times. More often than not, one finds the mother laying down the law for her child-on playgrounds, social life and in school. This type of rule making for the child gives him/her the inner strength to make something of himself/herself.

Society creates an umbrella for the parent and child. Schools, doctors, shops, environments of toddlers’ groups, support groups etc. make up the circle around the mother/father/child/family. These circles provide the environment within which we find a nest to settle into and feel safe.

The circles that bind us and keep us safe.

Mother-the World and the Nest

The Mother is used as a broad term in psychodynamic thinking – it can include the environment in which a child grows as well as the actual mother. In some cases, the father is more maternal than the mother.

We have no control over who gives birth to us. It is the first and most powerful experience with another human being and much as we love and hate her in later life, we are deeply and irreversibly influenced by her – both genetically and psychologically.

She makes up our external world and her reflection and her shadow falls within, in our internal world. Some of us idealise mothers, others feel ambivalent and another group hate their mothers. There is a big majority which sits in the middle, feeling all the feelings of love, hate and ambivalence.

In her absence, one begins to understand how much of her is inside us -in one’s internal world.

If we are able to create and maintain good relationships, overcome the troubled times and continue to live life in a deep and satisfying way,it is felt that there is a good mother inside, who prevails over the bad one (felt during bad times) and continues to feel that life is worth living.

Suicide -Wounds that Don’t Heal

Suicide is the single most self destuctive act. It means that all the attachments in the person’s life have not been enough to contain their hopelessness, rage and despair. 

People become alone and isolated internally.  They may be angry with those around them who they could not connect with. More often, they feel hopeless-unable to see past their present issues. The sense of self value hits a new low. Thoughts such as, ‘I am better off dead’, ‘my family will benefit from my insurance’, ‘I really don’t matter’, ‘they will know how low I was feeling’…..

Then a prevailing depression hits a new low – a sense of uselessness, the pain of not being connected with is turned on themselves…..taking action against the low and depressed feelings feels empowering. So, planning their suicide becomes an empowering experience against the experience of prevailing hopelessness and not being of any value.

A perceived rejection, unfair and cruel acts done towards them can all be reasons to kill oneself. The suicide can be saying, ‘you misjudged me’ ‘you thought I was making it up’. In any suicide case, it is clear that the person did not feel there was hope in life and they did not see any way to go on.

The underlying psychology would be something like, ‘I will rest in peace…I won’t have to struggle anymore’. ‘Others will be benefit from my passing…they won’t have to deal with my poorly self’. Here you can see how hopeless it has been-the person has felt hopeless and is projecting it onto others. They are probably also not feeling they can be helped.

Our relationships anchor us to this life and this world. Relationships that are attuned and able to touch the deeper core of strong emotions within us, keep the channels of communication open and reduce the chances of strong negative fixations taking hold. The life instinct overcomes the death instinct and manifests in good relationships, creative hobbies and pursuits.

For the suicidal person, somewhere, connection has been lost and paranoid-schizoid feelings dominate. People become deeply disturbed, suspicious and angry with their near and dear ones. These are not necessarily people who are physically alone. They experience loneliness even among others.

They do not feel understood. Their anguish remains a silent scream inside. Psychotherapy which deals with a discussion of aggression is useful at such times. The therapist engages with underlying aggression and resentment and even if the suicidal person does not like the engagement with his/her darker feelings, it tends to reduce the life force invested in suicidal ideation.

Some therapists will say that this is not true. They feel that those who commit suicide are not passive in their aggression. Consciously, this is true. Consciously, the suicidal person, gives up his aggression with self destruction. the suicidal person has no sense of his/her own ‘presence’ and identity left. He/she feels like a burden to himself/herself and ideas such as my insurance will go to my family might occur. Now what does this mean ? That ‘family’ will be happier for the money from a dead person ? So many clients suffer from guilt for having had to use the money from the dead person’s insurance, even if there was no suicide. It changes a person, having to use such money.

Some suicidal people seem to forgive everyone around them before dying, passing on their mixed feelings to those who survive them. This happens in the event of any death, if the person dying has had time to think about it. Forgiving everyone before leaving the world is possibly one of the healthier options.

So why takes one’s own life? Any method to do so is violent, especially hanging oneself, administering awful toxins etc. Suicide ideation is strong. The thought of ending the despair, worthlessness, anger and loss the suicidal persons are feeling become paramount. It becomes an ideal, a fixation.

Many suicidal people have expressed feelings that were ignored or passed off by those around them. We frequently become nervous when we hear people talk carelessly about death, their own or anyone else’s. These are warning signs-if you feel odd, nervous etc it is because it is potentially dangerous.

Depression-Not so Blue ?

The predominant medical view is that depression is a mental disorder and anti depressants and psychotherapy maybe prescribed to manage it.

Depression is characterised by sad mood, the inability to derive pleasure from activities such as seating or sex, and changes in psychomotor, sleeping, and eating patterns.

This may sound all doom and gloom but research is re-evaluating depression and asking some important questions. The unusually large numbers of people who now get diagnosed with depression leads to the question whether it is not a bit of over-diagnosis and can we step away from resorting to medication where possible.

Therapy seems to be a more healthy alternative and can be a good space to take inner rumination to, avoiding too much isolation.

According to an article in the American Psychological Review (2009) ‘The bright side of being blue: Depression as an Adaptation for Analyzing Complex Problems’, the authors (P.Andrews and A. Thomson Jr ) suggest that depression maybe a natural response to help an individual avoid outside stimulus and apply his/her mind to resolving complex inner problems.

They say, ‘Depression is the primary emotional condition for which help is sought. Depressed people often report persistent rumination, which involves analysis, and complex social problems in their lives.

Depressed people may withdraw into an internal state of preoccupation where they seem to ruminate. They may slowly isolate from others and insulate themselves from the outside world.

According to the article, ‘Analysis is often a useful approach for solving complex problems, but it requires slow, sustained processing, so disruption would interfere with problem solving.

The analytical rumination hypothesis proposes that depression is an evolved response to complex problems, whose function is to minimise disruption and sustain analysis of those problems by (a) giving the triggering problem prioritised access to processing resources, (b) reducing the desire to engage in distracting activities (anhedonia), and (c) producing psychomotor changes that reduce exposure to distracting stimuli.

In other words, the authors suggest that a certain amount of preoccupation and privacy may be required to think about and resolve life’s complex problems, whether it is at the workplace or in domestic life.

As a society we have ensured that workplace meetings be relatively without interruptions and have maximum privacy. This is to encourage a more focused and deeper thinking about workplace issues by avoiding all other distractions.

However, popular ideas which dictate how social and family life should be do not make space for such a condition. The sometimes stereotypical mingling with others is encouraged to fight what is considered an illness and anyone who wants to opt out maybe considered either ‘boring’, a misfit, unwell, antisocial or unpopular.

It is difficult to live with someone who is depressed. Family and close friends begin to feel the pinch of being with someone who is quite unavailable emotionally. They may experience useless, angry and pent up feelings.

According to the authors, depression as it is defined medically, is prevalent in industrialised societies where such a study was held but it also exists in small societies wherever it was possible to conduct such a study.

They go on to say ‘such evidence suggests that much of what is currently classified as depressive disorder represents normal psychological functioning (Horwitz & Wakefield, 2007).

One likely factor contributing to over-diagnosis is that clinically significant impairment is not conclusive evidence of disorder (Spitzer & Wakefield, 1999). Impairment can be caused by biological dysfunction, but it can also be caused by properly functioning stress response mechanisms.’

Though clinical and severe depression over a long period of time is not to be taken lightly, the usual bouts of milder depression maybe seen as a human and natural response to the need for resolving complex issues.