Choosing a counsellor

More and more people are curious about counselling and psychotherapy (two words for the same thing, I’ll use the word counsellor) but it can feel overwhelming to choose the right person. In this blog I’ll highlight some of the ways you might decide on who to contact.

Searching directories - there are lots of directories, some are run by regulatory bodies such as the NCPS, BACP or UKCP. All therapists will belong to a professional organisation that provides ethical and professional frameworks, and will regulate the level of training that their members have undertaken. Many counsellors will also be listed under other directories such as Counselling Directory which include a broad range of counsellors with different qualifications and experience, all of whom are accredited by one of the professional bodies.

You can search for what you are looking for support with (eg anxiety and depression), how you want to experience therapy (face to face, online, phone, walking), your access requirements (wheelchair accessible, hearing loop). Counselling Directory allows you the option of selecting an introductory call, and there are often introductory videos included in the profile so you can get a feel for the counsellor’s voice, style, and where they work from.

Looking at profiles

Photos

Often the standout part of the profile will be the photo - so ask yourself, what do you think? Do you like their smile, do they look professional or approachable? It’s okay to have a strong response to a photo, and for some people this will be the biggest factor in who they choose to contact.

What type of therapy are you looking for?

Some prospective clients are looking for a certain style of counselling, but most are not clued up on the 100’s of different styles of support available. When reading a profile the counsellor might describe what approach they are trained in. They might use jargon such a ‘person centred’, ‘humanistic’, ‘gestalt’, ‘integrative’. If you don’t understand the language, and they don’t explain what it means in their profile, it might tell you something about them, or you might be impressed, or reassured, or want to know more. You can find out about the plethora of different types of counselling here, or you could contact the counsellor to find out more. It’s worth remembering that the research strongly suggests that the biggest factors that contribute to counselling being helpful are the relationship between the counsellor and client, and the client being ready for counselling; not the modality in which the counsellor was trained.

Where do they work from?

The environment that counselling takes place in can make a real difference to some clients; some counsellors will show photos of the space on their website or directory profile. You may know that you want to be face to face with the counsellor, or you may prefer to be in your own home. Perhaps you feel safest there, or it reduces the cost of accessing counselling, or it means you can fit counselling into your schedule effectively, or the counsellor that you want to see lives too far away for you to travel to. If you are looking for online or phone counselling consider if you can create the right conditions in your home - a private space is important so you can fully engage in the counselling and establish a meaningful connection with the counsellor. Don’t worry about having to create a stylish, tidy space for online sessions; your counsellor’s non judgemental stance will extend to what they see on the screen!

Some counsellors will offer walking therapy which can provide a multitude of benefits such as the calming movement of the walking, being in natural surroundings and reduced eye contact. They might offer some face to face or indoor sessions first, or work solely outside. They might reference the environment, the weather or the seasons in their work with you (eg how the weather impacts your mood, or how you feel about a closed footpath) or it might just be the backdrop.

Practicalities

Don’t underestimate the importance of practicalities! Are you okay waiting outside the room for the session to start (sometimes outside), or do you want there to be a waiting room so you can arrive early? Will you be able to travel there easily on bus, foot, bike, car? What times and days can you make? If you are a late riser an early session will probably not be therapeutically beneficial. Do you need a toilet to be available?

Recommendations

Perhaps you have a friend or colleague who is really keen to recommend their own counsellor. It’s worth listening and checking out who they have seen, and asking them what they found helpful, but remember counselling is a deeply personal experience and what happens in the counselling room between your friend and their therapist is unique to them. There are strict confidentiality rules in counselling so your counsellor should not divulge anything about who recommended you to them.

An introductory chat (usually 15-20 mins)

Some people will arrange to chat to a few counsellors, others will have a strong feeling about one, and will reach out to check out if their instincts are correct. Whichever you’re doing there’s no right or wrong way to approach the conversation. If you’re happy winging it - you can see what comes up in the moment, and how the counsellor responds. Other’s might think about what they want the counsellor to know about them, or what’s happened to them. You might have some direct questions around the counsellor’s experience, or style of working. There’s no pressure to make a decision about whether to book a first session in that phone call, but it’s also okay if you get a good feeling and want to ‘seize the moment’. Occassionally I get a booking from someone who doesn’t want an introductory chat at all, and that’s absolutely fine. The first session can be an introduction in itself, you can choose whether to return for more sessions after that.

Specialist organisations offering support

There may be specialist organisations in your area offering free or low cost counselling. Counsellors working within these services should have had some training in a specific area of work and be supported by managers and supervisors with specialist knowledge. I work for a service that supports clients who have experienced sexual abuse. This service, and others like it may provide other services such as Independent Sexual Violence Advisors, helplines and peer support. When accessing counselling through an organisation you will not be able to select your counsellor, but if you felt that the counsellor that you are allocated was not helping you, you could bring this up with them or the service manager. A downside of accessing counselling through an organisation is that there may be long waiting lists, meaning waiting weeks, more likely months, before starting sessions. Examples of agencies working with clients that have experienced sexual abuse in Sheffield and surrounding areas including SAIL (Derbyshire), SRASAC (Sheffield), Saffron (Sheffield), ROTHACS (Rotherham), DRASACS (Doncaster).

If you would like to contact me for a chat about counselling, don’t hesitate to drop me an email samrobbkingcounselling@gmail.com, or message me on 07775888249.

I’d love to hear from you!

My Christmas Window of Tolerance

Do I enjoy Christmas? It’s an interesting question.

I think my current feeling is that I enjoy bits of it, but I’ve always found the social pressures difficult, and as I’ve got older, and as Christmas has got more commercialised, it’s become a time of year when I have to actively manage myself. This article by Mind is helpful in identifying all the ways Christmas can be hard.

I acknowledge it's nice to have a celebration to lighten up a dark time of year, and with that in mind I’ve tried to find ways to embrace aspects of the festivities, but I do my best to keep in my Christmas ‘window of tolerance’. The window of tolerance is a model by Dan Siegal, and it’s used a lot in working with trauma survivors. I don’t have Christmas trauma in my past, but nevertheless it’s a tool I come back to again and again with clients.

Let me try and describe the window of tolerance. Imagine a window, and through this window you can visualise something that makes you feel that everything in your life is okay. You might imagine a holiday memory, a natural landscape, or maybe, a Christmas tree with twinkly lights. When you look at this window, everything feels managable. Tricky things may happen, but you can cope, Good things may happen and you can enjoy them.

However, sometimes, when life is difficult this window can get squashed; distorting it, minimising it, making it more elusive. You may know that your window of tolerance has got smaller by how you are being. These ways of being are described as hyperarousal and hypoarousal. Hyperarousal feelings are anxiety, overwhelm, wanting to run away or fight to protect yourself. Hypoarousal feelings make you want to shut down. You might feel depressed, or numb to what is going on around you. If you’ve experienced trauma then these feelings are not something you can control, they are likely to be triggered by emotional memories that you might not be consciously aware of. So, for example, if you’ve experienced a bereavement at Christmas, you might find yourself getting hyperaroused when doing something that unknowingly reconnects you back to that loss; maybe opening a well meant gift, but having a feeling of numbness and disconnect.

So what can you do about this? 

One of the simplest, but not necessarily easiest ways of managing hyperarousal and hypoarousal is to be curious about what is happening when you experience them. This engages the problem solving part of your brain and may enable you to identify what you can do to help yourself. For example, if you have noticed that opening presents takes you outside of your window of tolerance, you might go on to recognise that you need to feel comforted in that moment to get back into it. You might achieve this by consciously breathing deeply and gently as you unwrap the gift; or you might imagine yourself giving yourself a hug, or you might feel able to say to those with you that it’s hard for you to open presents and feel able to receive their comfort. 

Talking to others about how they create a Christmas that they can enjoy might be helpful. I love this article by Beacon House on creating new traditions. Things that help me to stay in my own window of tolerance at Christmas include:

- having rituals that are meaningful to me that show my love for others, such as making gifts for my family (see my attempt to knit mini Christmas jumpers in the photo!)

- not feeling pressured into present buying - I’ve negotiated with friends and family over the years so now only buy gifts for a small number of people

- prioritising events where I feel connected with others, such as through singing or music

- accepting that what is portrayed as normal at Christmas is not the reality, and at times I’ll feel lonely

- spending time on my own doing peaceful activities away from the bright lights, but at other times enjoying the craziness of the tinsel and sparkle.

- being aware that we all have different languages of love, and trying to appreciate how others show theirs to me

Coping with the death of a baby: a compassionate and practical guide

The loss of a baby during pregnancy is a deeply painful and personal experience. I want to offer you some practical, but compassionate suggestions on how to navigate this incredibly difficult time. Throughout the blog I’ve included links to organisations and information that will help you feel to less alone, and understand your response better.

1. Allow yourself to feel whatever you need to feel

There is no one response to the end of a pregnancy, or the death of a baby. You may be experiencing a terrible sadness about never getting to know this baby or babies, or hold them in your arms; or you may feel guilt or relief that you ended the pregnancy. Some people may be able to rationalise the loss and will find comfort in nature taking its course, or a higher power deciding upon the fate of the baby. Others may feel a total annihilation of what they expected of their bodies and their future lives, and find themselves in a dark and lonely place. It’s okay to feel any of these feelings. They may feel unbearable to begin with, but you will find ways to live alongside them in time.

2. Find compassionate support

Friends, families and colleagues will have their own thoughts and feelings about the death of a baby or the end of a pregnancy. Some people have a fantastic affinity for knowing what support you need, but others may want to deny, minimise or fast track your grief. It may be helpful to think realistically about who can really help you, and how. Do you want someone to come round and make you cups of tea and comfort you, do you want practical support with cooking and shopping, or do you want someone to help you organise a funeral or remembrance event? People may be relieved if you ask them to give you what you need.

If you are parenting with another person they may be a great source of support, or they may be grieving in a different way to you and you might need to give each other time and space to process your grief in whatever way you can. Some people may seem to want to avoid talking about it, and may get very engrossed in work, or tasks. Others may want to talk about nothing else.

If you are struggling to find what you need from your friends and family you might want to have a look at the organisations who offer support.

Stillbirth and Neonatal Death Society (SANDS) runs a helpline, and has local support groups where you can spend time with parents who have also experienced a loss. It has specific support for parents from Black and South Asian communities.

The Legacy of Leo is a page for LGBT families who have experienced baby loss. They have stories to read, and a Facebook group.

The Miscarriage Association has a helpline, local support groups and online chat.

Tommys has really comprehensive information about all types of baby loss as well as stories of baby loss from other parents.

3. Find comfort in grief theories

I’ve learnt from experience that it’s helpful for people to know a little bit about theories of how people grieve. It can help them make sense of what is happening to them, and to feel less alone with the intense feelings.

I have 3 favourite theories that I learnt as a Bereavement Supporter at Cruse, a charity dedicated to supporting people who are grieving. The Cruse website is a fantastic resource for understanding the physical and emotional impact of grief.

Growing Round Grief - this theory was developed by a counsellor who was supporting a women whose child had died. Her grief felt all encompassing - no part of her life was unaffected, so she didn’t believe she’d ever get over the experience, despite what people kept telling her. However, what she learnt was that she could grow her life around her grief, and this way she always felt the connection to the child who died. SANDS captures this poignantly in this video

William Worden’s 4 tasks of grief are -

1) accepting the reality of the loss - this happens over time, for example each anniversary of the loss may create more acceptance

2) processing the pain of the grief - this is the hard work of grieving, for example feeling the intensity of the feelings, and the physical pain of having empty arms

3) adjusting to a life with the loss - this is where you will develop a new identify that will incorporate the experience of the loss. You may reevaluate your values, your spiritual beliefs and your relationships

4) developing an enduring connection with the deceased, whilst embarking on a new life - this is the balance people achieve between honouring and remembering their baby, whilst living a new life. For example I had a client who decided she would collect small objects when on holiday and keep them in a jar, as a way to remember the babies she had lost and what she might have been able to share with them had they lived

You can read more about this theory at Child Bereavement UK. They also have lots of videos exploring different aspects of grieving for a child.

The Dual Process Model of Grief captures how people oscillate between being in the depths of grief (eg feeling depressed with no motivation) to being focused on what the future will look like (eg enjoying going to the cinema with a friend). It’s very common to feel guilty when experiencing any pleasure, however it is extremely tiring on the mind and body to grieve all the time. Oscillating between being with grief (loss oriented grief), and looking to the future (restorative oriented coping) is important and normal. Taking time to meet with a friend, watching a comforting or funny programme, immersing yourself in a good book, having a bath, or going for a walk are restorative, and they will give you the energy to return to the hard work of processing your loss. Julia Samuels, a psychotherapist specialising in loss, captures describes the dual process model here:

4. Show compassion to your body

Whether your loss was early or late in pregnancy, your body will be impacted by both the pregnancy and/or birth, as well as the grief you are experiencing. Try to rest in whatever way you can (sleep, read, lay down, walk), eat simple, nourishing food that is easy for your body to digest, and move gently when you feel ready. Taking care of your physical health can be difficult when your head and heart are hurting, but small acts of self-care will help your body recover, and will help your mental health too.

If you gave birth to your baby, you may be connected to your loss through bleeding after birth, or your milk coming in. These physical changes can be a very visceral reminder of what you have lost, but they may also be cathartic. If you are lactating you may want to consider donating your milk to a milk bank, to help vulnerable babies. Some people find this is a way of feeling that their baby has had a positive impact on the world.

4. Remember your baby

There are many different ways that people remember their babies. It may be a very private experience, or you may want to display photos, arrange special events or raise money for organisations that supported you along the way.

You may want to create a box of memories that you can add to as the years move on, or you might want to have annual rituals such as remembering the baby at Christmas, or including their name in conversations or when signing greetings cards.

Some families like to have their loss officially acknowledged, and in England the government now provides certificates if your pregnancy ends before 24 weeks (or 28 weeks if your pregnancy ended before 1 October 1992). If your pregnancy ends from 24 weeks onwards, you need to register a stillbirth instead.

5. Talking to a counsellor or psychotherapist

If you would like to talk to a counsellor or psychotherapist about your loss you can find details by using a platform like Counselling Directory.

If you’d like to work with me, I offer a free 20 minute conversation on the phone or on Zoom. If you’d like to arrange that drop me a message at samrobbkingcounselling@gmail.com or message me on 07775888249. Some clients will find just a few sessions makes a massive difference to their wellbeing.

I work face to face in Sheffield, S7 and online and by phone.