“So, tell me about your childhood…”

It’s one of the most popular stereotypes of psychotherapists, that we just want to talk about past experiences and blame everything on your parents! No wonder when people approach our services for help, they often stress that they want to let go of past events and stick to their present troubles.

After all, if you can find tools to tackle your current problems without digging up memories of painful times, why bother? The past is the past, right? There’s nothing you can do to change it.

Well, kind of… you can’t change your past experience, but you can change your thoughts and feelings about it. And you can change the power it has over your mind and your current life.

How our childhood shapes our personality

Lindsay Gould, a therapist working in London and Brighton, offers the example of a man who has been admonished for crying. “If, when in pain as a child, he was told that crying’s babyish or not masculine, he is likely to take that belief with him into adult life. He may feel incapable of expressing emotion, particularly fear and hurt, if he thinks that shows weakness, and that is likely to impact his relationships. Through recognising the source of the belief, he may realise that he can dispute it.”

That last part is really important. As young children we tend to believe what adults tell us, without questioning it. So if a parent tells their son that crying is babyish, then the boy accepts that.

He carries the belief with him into adulthood, feeling it as a natural truth. Even if people tell the man it’s fine to cry, even if he gets it rationally, the belief that crying is babyish still feels true to him.

He might have problems in an intimate relationship as an adult, because he can’t show his partner when he’s hurt. If he is given the guidance ‘You just need to open up more when you’re upset,’ it probably isn’t going to help because that feels so wrong to him.

To change his feelings and behaviour in a way that sticks, he needs to change the underlying belief. And to change the underlying belief, he needs to understand that it is just a belief, not a truth. This involves reflecting on his early experiences and acknowledging the impact of all the times others told him to stop crying or praised him for being a brave little soldier.

These early beliefs we hold onto come in lots of different flavours, many of them negative. Some of the most common are I’m weak, I’m unlovable, I’m stupid and I’m too much. These are all variations on the I’m bad theme, but children also absorb beliefs about other people or the world in general – others can’t be trusted, the world is a dangerous place, women are manipulative, and so on.

So many of these beliefs that underpin our adult behaviour just aren’t true! Sometimes, the people we picked them up from don’t even believe them themselves. The parent who tells their son to be a brave little soldier might only be doing it because they can’t bear the hurt of seeing their son crying. The reason a child calls a classmate stupid might be because they fear that they’re stupid themselves. The grandparent who declares their grandchild ‘too much’ might just be embarrassed that they haven’t the energy to keep up.

Yet the child hears these things and takes them to heart, embedding them into their personality. They incorporate these beliefs into a blueprint for how the world is, then they look for evidence that that blueprint is right.

So the next time a teacher says “There there, don’t cry,” to our brave little soldier, he remembers what his parent said and hears the teacher’s comment as a rebuke (you shouldn’t cry) rather than an attempt to comfort him. In this way, the beliefs get reinforced.

We all do this – looking for things that fit with our blueprint and dismissing things that don’t – as we feel more secure when our blueprint isn’t challenged.

Early experience and relationship style

Sara Barry uses an attachment-based approach in her psychotherapy practice. She finds that for many people, the area where their blueprint causes most problems is in relationships.

To greatly oversimplify attachment theory, if our significant childhood relationships were secure due to our parents/caregivers being attuned to, and responding to, our needs and helping us to manage our emotions, we will likely be able to form secure relationships as adults. However, if we felt insecure in these early relationships, we may find it harder to form healthy adult relationships.

Imagine a girl whose parents are neglectful. Instead of having an experience of how a healthy relationship feels, she grows up learning how to be in relationships with neglectful people. When she is choosing who to form an adult relationship with, she may unconsciously choose a person who will neglect her, because that feels familiar and fits with her blueprint.

Developing an understanding of her attachment style and its origins can help to loosen the control that her past has over her, and help her to have more choice in her present situation. As Sara points out, “What we can change by talking about past relationships is how we think and feel in the present, and that offers choices for how we want our future to be.”

We can change not only who we are in relationships with, but also how we are in relationships. As a child, the girl with neglectful parents will develop coping mechanisms (ways to help keep herself safe from the neglect). Perhaps she will become very independent, looking after herself because she cannot rely on her mum and dad to do it. When she grows up, she is likely to behave in the same way in her adult relationships, even with people who don’t neglect her.

This might seem strange – why doesn’t she see that the coping mechanisms no longer help once she’s away from her parents? It’s partly because the coping mechanisms are unconscious habits – she doesn’t realise she is behaving that way or may not know how to act differently – and it’s partly down to her blueprint. Her blueprint says that others are neglectful, so she expects partners and friends to be neglectful and looks for any hint of inattention as evidence that they are.

She may then revert to the old and familiar ways to cope by that served her so well as a child – relying only on herself. Only now they might not serve her well. Instead they may create problems – her partner may complain that she takes charge of everything, her friends may be hurt that she doesn’t open up to them, she may find it hard to delegate at work, the stress of doing everything on her own may impact her health, and so on.

Learning to let go of the past

So, the coping mechanisms that serve us well as children often create problems in our adult relationships. Integrative therapist Ben Marks explains it to his clients with the metaphor of an army with out-of-date strategies.

“This army has never evaluated its past and is stuck in patterns and rituals that are no longer appropriate. An air craft carrier isn’t going to stop terrorism. Once you understand and evaluate your history, you can deal with the present.”

Ironically, letting go of the past doesn’t mean forgetting about it or ignoring it. Rather, we move forward by looking at our past lives, facing difficult memories and learning how they impacted our mind and thus affect our present situation. By doing that, we reduce the power of the past over us, and we start to notice improvements across our lives – in relationships with others, at work, in our health, and so on.

Looking at the past can feel scary

If you fear looking at your past, remember that you will always be in control – our therapists are there to help and guide you; they aren’t going to force you to talk about anything you’re not ready to.

And in my experience, clients often expect looking at their past to be harder than it turns out to be. They also tend to be surprised by how much it can help their lives, and to be glad they made the decision to go there.

Kate Crawford is Head of Therapy Services at One Therapy London.

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Some people think their problems aren’t significant enough. Others fear they have too much to say, that they might overwhelm the therapist or open a can of worms they won’t be able to close. Some worry that there are right things and wrong things to talk about in therapy, that they don’t have the proper language or that there’s no point in talking about anything as it can’t change the past anyway.

All these worries are normal and completely understandable. They are also unwarranted. There is no right or wrong way to talk and no subject matter that can’t be explored. Most clients who struggle with what to say find that it becomes easier with a little time. Therapists are trained to help people talk, and the empathy and non-judgemental approach therapists adopt soon enables clients to open up.

For those who think their problems aren’t important enough, that just isn’t the case. If something affects a client, then it’s worth talking about. Caspar Murphy, who works at One Therapy Brighton, says, “As a therapist, I am interested in each individual who walks through the door. Often the clients who think their problems aren’t important are the ones who haven’t been listened to much in their lives. Helping them to view their thoughts and feelings as important is a crucial part of the work.”

The boundaries that therapists put in place can feel very containing for clients who worry about having too much to say or opening a can of worms. Clients are encouraged to go at their own pace, without any pressure to go into topics they are not yet ready to address. At One Therapy, we provide open-ended counselling. That means clients can come for as many months or years as they want to, so there’s no rush to talk about everything straight away. They speak to the therapist for 50 minutes once a week and they don’t have to think about their issues between sessions if they don’t feel able to.

Therapy is not always easy but it may be less difficult than you might think.

Many clients find that exploring difficult topics and sharing them with the therapist isn’t nearly as overwhelming as they expect. They also see that the therapist can hear whatever they have to say and be okay with it. This shows the client something really valuable: that they and their story are not “too much”.

As integrative therapist Amrita Athwal points out, learning about our pasts helps us make sense of the present and exploring the present sheds light on unconscious material from our pasts. With the therapist’s help, the client makes links between the two, thus understanding themselves better.

For some the worry is how they should talk. Are they allowed to swear? (Yes.) Do they need to keep a lid on their emotions? (Absolutely not.) Will they need to understand terminology like the unconscious, the ego, transference, and so on? (They won’t.) It is the therapist’s job to talk in a way that their client can understand, and there’s no need to use technical terms. Clients are free to talk however they want to talk and to use the words they would use if talking to a friend.

Finally there are those who think there is no point in talking about anything in counselling. Psychodynamic therapist, Claire Coupe, acknowledges that talking doesn’t change the past, but says it enables us to “process our feelings and understand the impact these events or experiences have had on us. It helps us to tolerate the difficult emotions we often try so hard to bury.”

Please try to put aside your worries about what to talk about. Whatever you want to say and however you want to say it is fine with us.

Kate Crawford is Head of Therapy Services at One Therapy London.

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I’m often struck by the anxiety that I see on the faces of clients when they come to their first couples therapy appointment. They are invariably wondering what’s going to happen.

Will they have to reveal things they don’t want to say in front of their partner? Will their partner say things they don’t want to hear? Will I judge them for how they are in their relationship? Will I push them to stay together when they want to separate, or to separate when they want to stay together?

With all these fears, it’s not surprising that many couples put off therapy until they reach crisis point. I advocate coming before the relationship reaches a crisis. It’s easier to resolve issues without the threat of separation hanging over the couple or the therapy. I hope that by explaining a little about what happens in couples counselling in this post, I can alleviate some of the fears and help couples come to therapy sooner.

Relationship therapy with your partner isn’t always easy but it may not be as frightening as some might think

Firstly, the therapist’s role is not to judge either partner in the relationship, nor to tell them what to do. The role of the therapist is to help the couple have the conversations they need to have to work out how they want to go forward. I can’t think of a couple I’ve worked with where the core of the work hasn’t been improving communication. As Helen Rattner, who sees individuals and couples at our Brighton practice, points out, “Although we are pack animals, we find the rules of engagement with our fellow human beings a tricky affair. We often dance around each other rather than dance together.” And there are many ways in which we can help you to dance together.

It’s unrealistic to expect two people to live alongside each other without friction. We all do things that irritate, hurt or infuriate our partners. I’m talking about big things and little things here, from infidelity, sexual problems and abusive behaviour to not taking the bins out or leaving the lid off the toothpaste. In couples therapy, we unpick why those things impact us as they do, how to communicate that clearly and what changes can be made going forward.

Tom Leonard specialises in couples work. He finds that when couples come with what they see as irreconcilable differences or unchangeable patterns of behaviour, counselling often helps them to understand those things in new ways and make shifts that didn’t previously seem possible. An important part of that process is recognising that both partners are responsible for the relationship and for their part in the problematic dynamics.

Therapy creates a space where both partners are treated equally, where both voices are heard and the therapist is an impartial third party. Many couples remark on how valuable that space is: 50 minutes a week to focus on their relationship away from the stresses of work, family and home.

This space provides the opportunity to improve many areas of the relationship: restoring intimacy, building trust, overcoming past infidelities, reducing aggression, resolving financial problems, sharing domestic responsibilities fairly, parenting effectively together, adjusting to retirement, managing relationships with wider family – the list goes on.

The therapist helps the couple to discuss issues such as these and to agree their way forward. In doing so, the couple learns to negotiate difficulties effectively themselves. Our aim isn’t to eliminate disagreements, but to equip the couple with the ability to work through them.

Ultimately, some couples will decide they want to separate – and it is always their decision. Couples therapy provides support through that process. Indeed, couples sometimes come to us having already made that decision and wanting our help to reduce the fallout, particularly if they have children. Delia Schumacher, a psychodynamically-trained couples therapist at our Soho practice, stresses the importance for the couple of mourning the relationship and reflecting on what the ending means for them.  It’s so easy for separation to degenerate into a blame game at a time when both partners are already hurting. Keeping communication open and compassionate with the help of couples therapy is invaluable.

Whatever stage a couple is at, there is no shame in coming to couples therapy. Keeping the love and communication going through all that life throws at us is a real challenge, and one that most of us are never taught how to handle. We’re here to help.

Kate Crawford is Head of Therapy Services at One Therapy London.

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When I trained as a psychotherapist, me and my fellow students were given the assignment of doing something we’d never done before. The course tutors wanted us to get in touch with how scary it can be to do something new, to feel the fear of the unknown. I chose to jump out of a plane, which seemed a little excessive when I found out that a fellow student had chosen to bake their first cake! But actually, when I consider the fear that some people feel around coming for their first counselling session, I think it was a good choice.

New clients generally come for their first sessions full of anxious questions. What will happen in counselling? Will you give me a diagnosis? What should I talk about? Where should I start? Do I lie on a couch? Is it ok to cry? Or to swear? What will the therapist think of me? Can they fix me? And so on. I hope that by answering some of these questions here, I can make it a little less scary for you to embark on counselling.

Counselling in a unique experience for everyone — so expect the unexpected

First, let me paint a picture for you of what happens in the counselling room. You and the therapist sit across from each other and talk about whatever you want to talk about. That’s all. In your first session, the therapist may take notes. After that, they probably won’t.

Ceri Hiles, who is based at our Covent Garden practice, points out that many people’s expectations of counselling or therapy are based on what they’ve seen in films. “If your idea of therapy comes mostly from the movies, then you might have a rather unhelpful sense of what it is like. You probably won’t be reclining on a couch while a severe, bearded man peers at you over his glasses and asks questions about your mother!”

These days, the therapy relationship is much more equal, with the therapist and client working collaboratively. Therapists don’t diagnose and we don’t fix. That’s because you’re not broken. Our job is to be alongside you as you work out who you are, what you want from life and how you might get it. Therapists support and guide their clients, and together the therapist and client can create amazing change, but it’s not a case of the therapist telling the client what to do or prescribing a magic pill.

So, what to talk about and where to start? Psychodynamic therapist, Barbara Perrini, stresses that every client’s experience of therapy is unique and there is no right or wrong subject matter. “It is very much individual, as it is about your personal experience and feelings. It goes at your pace and you talk about whatever you want to talk about in each session.”

Sometimes you might not know what to focus on. That’s fine. Your therapist will help you to get to the heart of the matter, whichever point you start from.

Some clients start in the past, some in the present, some talk about the same issue each week, some bring something new each week. It all works.

Your therapist will help you along the way

That said, there are effective ways to use personal counselling sessions and your therapist will support you to find what works well for you. Good therapists recognise that new clients may need a bit more help. For example, with a new client who doesn’t know what to talk about, I ask a few questions to help them start. As clients become more comfortable in therapy, they tend to need less of this.

Many clients want to be “good” at therapy and for their therapists to think well of them. That’s only natural and the client’s desire to be good can be valuable to explore in itself. But sometimes it gets in the way of the therapy. The more you can be yourself with your therapist, the better. That might mean showing parts of yourself that you usually hide, parts that are vulnerable, messy, dark and so on.

So yes, it’s ok to cry. And yes, it’s ok to swear. Therapists are used to all sorts of emotional expression. In fact, it’s one of the most precious things about counselling, that you can be yourself and be accepted just as you are by your therapist. Dwayne Jackson, who founded One Therapy, says, “There is something unique about the open, non-judgemental relationship between client and therapist that’s unlike relationships you get anywhere else. There is a unique type of honesty in therapy, shared only by the client and the therapist.”

So what to expect in counselling is on the one hand mundane – just two people talking – and I hope that this takes away some of the fear of the unknown. Because on the other hand, what to expect is something exceptional – a relationship unlike any other, which will support you to create what you really want for your life.

Kate Crawford is Head of Therapy Services at One Therapy London.

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Over the years that I’ve worked as a therapist, I’ve been asked numerous times by prospective clients, “How does counselling help?”  And I’ve yet to come up with a satisfactory answer. Not because I’m in any doubt that it helps, but because the how bit is so hard to articulate concisely.

Counselling works in a number of ways. One of these is simply that getting things off our chests usually makes us feel better. Many people don’t feel comfortable talking about their problems to family or friends. They don’t want to burden them, or perhaps what they want to talk about is too private.

Having someone whose role is to listen without judgement in a safe, confidential setting can be really precious.

If you haven’t tried therapy before, counselling may seem mysterious and confusing

Counselling goes beyond just listening. The therapist works to really understand the client, and in doing so helps the client to understand themselves. Psychodynamic therapist, Antonella Bonetti, uses the analogy of a messy canvas, covered in all sorts of colours and shapes. This canvas represents the client’s life experiences. Looking at them, some areas make sense, some don’t and some feel painful to look at. The therapist helps the client to make sense of the canvas and is alongside them when they look at the painful parts. With time, these painful parts become more manageable and, as Antonella says, “the initial confusing canvas may be transformed into a very different work of art.”

Counselling is about increasing self-awareness and making changes

An important ingredient in this transformation is compassion. Most of us beat ourselves up for not being good enough in some way or another. Having a therapist understand why you are the way you are and accept you just as you are can encourage you to be more compassionate with yourself.

Another important ingredient is awareness. As Brighton-based therapist, Mel James points out, positive change stems from awareness and counselling can hold up mirrors to our blind spots. Therapists help clients understand how events in their past influence their present beliefs and behaviours, and how those beliefs and behaviours may be hindering them. This increased awareness can liberate clients to choose different ways of being. As Mel says, “it can also help us reconnect with our true selves, leading to increased fulfilment in life.”

I still don’t think I’ve successfully explained how counselling works. There’s more that I could say. But ultimately it’s less important to understand how it works than to give it a chance to work for you.

Often clients tell me that counselling has brought benefits without them really noticing how or when the change happened – things shifted for the better without them understanding it. So my suggestion for anyone who’s considering personal counselling is to give it a try. It may be a leap of faith, but counselling can be so amazing and life-changing that it’s a leap well worth taking.

Kate Crawford is Head of Therapy Services at One Therapy London.

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