|
10/6/2026 Workplace Stress, Burnout and LeadershipEconomic uncertainty, organisational change, technological disruption, increased regulation, changing patterns of ownership and rising performance expectations all play a part in the increase in workplace stress and burnout. Management and leadership matter too.
27/8/2025 Why Continuity MattersWe live in a culture of flexibility and immediate access. Therapy apps allow people to choose a therapist, change therapists, book sessions at short notice and access support around existing commitments. Artificial intelligence can provide information, reflection and conversation at any time of day. For many purposes, these are valuable developments. Psychotherapy approaches problems differently. The purpose of psychotherapy is not simply to reduce distress in the moment, provide advice or techniques (you're likely to have accessed at least some of the vast amounts of both freely available on the web) or offer reassurance. It is to understand the patterns that create distress in the first place. People often arrive believing that anxiety, burnout, low mood, irritability, relationship difficulties or a loss of purpose are the problem. Over time, many discover that these experiences are symptoms of something less straightforward. Symptoms can change. Anxiety may become exhaustion. Exhaustion may become resentment. Resentment may become despair. If the underlying pattern remains unchanged, difficulties often return in a different form. This is just one why reason continuity matters. Professional counselling and psychotherapy are structured processes that take place within an ongoing relationship with the same therapist. The value is not found in a single conversation, a collection of techniques, or occasional emotional support. It emerges through the gradual development of a reliable therapeutic relationship over time, during which you are given the time to consider what else may be at play beyond symptoms. This can feel unfamiliar in industries that reward rapid problem-solving, adaptability and decisive action. Difficulties are addressed quickly. Resources are allocated efficiently. Underperformance is identified and corrected. That's good business. Life is not always as straightforward. The patterns that influence our relationships, ambitions, anxieties, decisions and sense of self develop over decades. Understanding them requires something different from a quick solution. It requires attention, consistency and time. The regularity of psychotherapy is not an administrative detail, it is part of the work itself. Like any meaningful long term investment, the benefits arise not from isolated moments but from continuity, consistency and the accumulation of work over time. If you find yourself frustrated with your therapist, reluctant to attend, bored, dependent, disappointed, angry or unusually invested in the relationship, these experiences are not interruptions to the work, they are often part of it. Similar patterns may emerge in professional relationships, family life, leadership roles and intimate partnerships. The therapeutic relationship provides an opportunity to observe and understand them in real time. Rather than immediately moving away from discomfort, psychotherapy asks what that discomfort might be communicating. The fee is not payment for a dose of comfort, advice or reassurance. It is an investment in a professional relationship designed to create the conditions for lasting change. The therapeutic frame - the agreed time, place, boundaries and continuity of the work - provides the stability necessary for that process. When the frame is reliable, difficult feelings can be explored rather than avoided. Anxiety, uncertainty, failure, ambition, resentment, vulnerability and loss are all very human and all have a place. Patterns that once served a purpose but have become limiting can be recognised and understood. New ways of relating to yourself and others become possible. This process much more than pivoting to become a different person. Its purpose is not immediate relief. Its purpose is sustainable change. 9/4/2024 The Cost of ConformityRonald Gittins died in 2019 leaving behind a home filled with his art. Five years on, his flat in Birkenhead, walls covered in his work, rooms crammed with sculptures and murals, has been Grade II listed. He lived there for three decades, left largely alone by landlords and agents, letting in only a handful of visitors. Enough of the right people came through at the right time to see that something extraordinary had been created, and to act so that his work would not be lost. We don’t really know how Gittins lived, how he paid the rent, what his days looked like. What we do know is familiar: people like Ronald often find it hard even to live with themselves. They are compelled to make, driven more by necessity than choice. Very few ever produce work the market wants, but that's rarely their concern. For many, art is not about money at all. He was of a generation that could find some support from the State. From the 1960s to the mid-90s, the benefits system in Britain acted as a basic income for many creative people. Writers, musicians, and artists who had little money but abundant time could develop their skills. Some went on to become successful; others simply kept producing in their own way. Now, no one is permitted that freedom. Families demand respectability, schools shape expectations, cultures ridicule the urge to create unless it is monetised. Banksy was a vandal until his work began selling for millions. The lesson is clear: what you make has no value unless it sells, and if you need to feed your children that message is particularly maddening. The consequences of forcing people into lives that don’t fit them are evident all around us. Some numb themselves, some break down, some end up in contact with the courts or psychiatric services. Many, many more live lives of bitterness and frustration, resenting others, abusing the smallest amounts of power, unable to tolerate those who remind them of what they cannot bear in themselves. Psychotherapy calls this projective identification: the parts of us that are disowned, are perceived and punished in others. None of us are immune. You don’t need to be an artist to feel this. Anyone who senses that their life does not truly belong to them will feel the strain. Sometimes it’s obvious: the genius mathematician having to schmooze investors, the barrister whose real gift lies in care. Sometimes it is harder to recognise, buried under histories where attention was conditional on being constantly brilliant, caring for a parent, being unwell, or causing trouble. People can succeed outwardly and still feel inwardly thwarted, and that dissonance leaves its mark on relationships, including those with children. There are no simple solutions. Ronald Gittins had a convergence of circumstances that allowed him to keep going in his own way. He was prolific in solitude. For most of us, conformity is necessary. We learn our trade, earn a living, secure some stability. If we're fortunate, we can create enough space to pause, to ask why we are doing what we are doing, to wonder which pieces of our lives really belong to us. Psychotherapy offers one of the rare places where that is still possible. A space to look at what compels us, what constrains us, and what might allow a life to feel more like our own. 5/4/2024 What Does 'Processing' Mean?We’re often encouraged to “process” our feelings, and to seek help if we can’t do it alone. But what does processing actually involve? More Than Just Understanding Processing is sometimes thought of as understanding. That makes sense when investigating a policy failure or a broken system: gather the facts, fit them together, draw a conclusion. But emotional experiences don’t work that way. When you’re left feeling confused, unsettled or “not yourself,” logic alone rarely helps. Something more is needed. The Warehouse of Memory Neuroscience suggests that ordinary events become memories we store easily, ready to use when needed. Opening your front door to the smell of good food can remind you that you can relax, while the skill of brushing your teeth doesn't interrupt your ability to drive. But unusual or difficult events don’t slot in so neatly. Imagine a warehouse carousel: Regular boxes → ordinary memories → stack easily and stay stable. Irregular boxes → fragile or unusual experiences → take more effort to store. If too many arrive at once, they bash into each other, spill, or circle endlessly. That's what it feels like when experiences remain unprocessed: intrusive, unstable, overwhelming, difficult to put down. What We’ve Lost Across cultures, rituals once helped to contain life’s irregular boxes. Bereavement, birth, coming of age, accidents . . . each was marked by shared practices that gave shape and meaning to experience. Many of those rituals came with an unspoken cost, and in the (often proper) rejection of those costs we also rejected the purpose of rituals, reducing them to empty financial outlay and performances. Without meaningful symbolic events, we're left unsure how to respond to events, with fewer containers for memory and fewer opportunities to process unusual experiences. What Processing Involves Processing isn’t limited to extreme or traumatic events. Everyday strains, sometimes genuinely pleasant events, can create their own backlog. Processing can look like: Taking time to reflect on events. Talking it through to find language that fits. Becoming curious about how it might connect to other experiences. Expressing it through writing, painting, etc Processing is a way of understanding events so that they can be understood more deeply and carried more lightly. Where Psychotherapy Helps An inquiry gathers evidence but does not attend to its visceral impact. Psychotherapy does both. Psychotherapy offers a space where events can be spoken about and remembered with care, feelings can be expressed and symbolised, and where meaning can begin to form. It is not about “getting over” events or returning to a pristine, untouched version of yourself. That is neither possible nor desirable. Instead, psychotherapy helps you make deeper sense of what has happened. It allows you to create containers that fit more comfortably, so that memories no longer rattle around or circle endlessly. The Work of Growth Processing isn’t a quick fix. It takes time. But when experiences are attended to in psychotherapy - without judgement or blame, with careful attention - they can inform new choices, different boundaries, and sometimes altered opinions. They stop destabilising the whole system and instead become part of who you are, not as burdens to be carried but as sources of perspective. Processing, in this sense, is not simply repair. It is the slow work of growth, the making of wisdom. If This Speaks to You If you recognise something of your own experience in this, psychotherapy can provide a steady place to begin working with it. Together we can begin to make sense of what truly feels unsettled, so that it can be processed, integrated and carried with greater ease. Burnout has become ordinary.
What used to be a pretty niche diagnosis, perhaps exemplified by the cliché of a male executive rearing out of his office chair, punching a wall and having to be led from the office, is now being seen in large numbers of people. It’s worth making a few distinctions. The World Health Organization defines burnout as "a syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed." It is “an occupational phenomenon.” “Burn-out refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life.” This is important. Burnout is linked to poor management in the workplace. Not to an individual failing to manage their own stress. Forbes says: We often think of burnout as an individual problem, solvable with simple-fix techniques like “learning to say no”, more yoga, better breathing, practicing resilience. Yet, evidence is mounting that personal, band-aid solutions are not enough to combat an epic and rapidly evolving workplace phenomenon. In fact, they might be harming, not helping the battle. With “burnout” now officially recognized by the World Health Organization, the responsibility for managing it has shifted away from employees and toward employers. The top 5 causes of burnout are
WHO emphasises the need for organisations to address systemic issues related to workplace stress, support employees in managing their workload and maintaining their mental health. By contrast, workplace stress:
There are periods when everyone’s employment becomes, or at least feels, dull and purposeless and this can be the impetus to seek promotion or a new role, or the realisation that things are not as they should be. Listen to those feelings, they exist for a reason. Take early responsibility to act on these feelings. If a project is dull, or even pretty brutal, but you know it’ll end, put things in place to support you. Tell friends that you love them but won’t have the time to be as social as you’d like to be for a while. Ask them and others who might want to, for help. It’s logical to realise that when a workplace requires a 50+ hour week and so many people are living alone, support is necessary; it’s something we can offer each other and request in return. Pay careful attention to how you feel when you imagine negotiating a change in workload. And think about what you need to do in order to move on from this situation. It’s bizarre that I need to write, ‘Try to get enough sleep,’ but there we are. Balancing sleep, rest, decent food, water, daylight, physical movement, human contact and work (all this before thinking about anyone else in your household) has become difficult for huge numbers of people. Please recognise that this is outlandish, reminiscent of the worst Victorian labour practices, and that you’re not alone. Get an MOT If difficult feelings aren’t attached to a particular project and have become ordinary, visit your GP, describe how you're feeling and ask about getting routine blood tests of red blood cell count, white blood cell count, thyroid function and blood sugar. When very basic physical things are not as they should be they can manifest as anxiety, depression, tiredness or becoming unproductive, and all the therapy in the world will not change that anywhere near as effectively as getting your basic health up to speed. Consider psychotherapy. Psychotherapy can help with workplace stress and burnout by exploring not only the pressures themselves but the deeper questions beneath them: why we do the work we do, why we tolerate conditions others might refuse, and how we can restore balance when things have gone awry. These questions matter at any time, but they become essential when the source of stress and exhaustion is the very thing that fills most of our waking hours. There are multiple, global causes of the increase in workplace stress and burnout. Poor management and poor leadership are two of them. The UK has a reputation for both. No one in their school careers interview says, “When I grow up I’d really like to make people’s lives a misery.” Few 5 year plans include denying responsibility for maliciously and intentionally harming people. But if you’ve watched even the smallest part of any public inquiry or read any report about any scandal, its clear that this is routine behaviour. Policies and procedures serve solely to minimise liability, not embed accountability, which is why the phrase, “Lessons will be learned” is so hollow. There’s no easy answer to this one. The UK simply does not invest in management training, if we remain in a profession long enough we're very likely to end up being a manager whether we want to or not. Meaningful structural, professional, strategic and cultural changes require time, expertise and enthusiasm, but there’s little motivation to invest in any of them. Accepting that, since so many people are poor managers and leaders, there might just be a chance that we too could be mildly suboptimal, is a start. Therapy - and I mean more than 6 sessions of goal focused CBT - offers the space and time to build an environment of trust so that you can safely consider what might be going on. Jerks, not all of whom are talented, seldom come to therapy. Take workplace stress seriously, take burnout very seriously. By definition, a lot of it is out of your control, but some of it is in your hands, even when it can feel as if it really is not. 'Tis the season, and a number of colleagues have sent me this useful piece about making this time of year more than a performative, almost competitive, excuse for the same kind of celebration people have at Thanksgiving, Christmas and New Year.
"The phrase “I haven’t allowed myself to grieve” comes up time and again. One friend hasn’t allowed herself to grieve for her mum for 11 years. Another drifted from someone she adored and never felt she had permission to mourn them. A pal describes her love and grief for her dog Buddy as tied up with her longing for a baby. We also share joy and memories. My sister brings my other hilarious, powerful granny. A friend shares the story of a grandad who brought him pure and uncomplicated joy." The Western Christian church dedicates this time of year to the rituals of Hallowtide variously called All Saints, All Hallows Eve, All Hallows, All Souls, and all religions and cultures have a season when they remember the dead, it's a human need. Although many of these rituals are not as solemn as Hallowtide they all acknowledge Ancestors and therefore speak to something about identity, lineage, belonging and loss. Most of us in the West have no idea what to do with our Ancestors. Samhain marked the beginning of winter, the return of livestock and the people who cared for them from higher pastures, the final harvest, serious preparation for winter, and events to reestablish living indoors with people you may not have seen for 6 months. "All is safely gathered in" includes the beloved dead. Now, we are allowed a couple of weeks off after our mother dies and then we get back to work as if nothing has changed. Indeed, work distracts us from what can be a cataclysmic loss. In the UK, the loss of a baby before 24 weeks gestation does not entitle the parents to any time off work, and the law offering parents of a stillborn child two weeks paid time off only came into force in 2020. There's something inhumanly mechanistic about all of this: 'entitlement' to grief having to be legislated for is barbaric. Display pictures of your dead. Frame them if you haven't already. There's still time to ask for their names to be read out in your local church. If religion isn't for you then at the White Spring in Glastonbury names of the dead will be read out on 31 October and you can send yours in via Facebook, where you can also take a look at Death Cafes. You can, of course, simply say their names yourself. None of us will escape grief, it is the price of love. The New Normal Charity is one of my favourite organisations supporting people who are bereaved. Free, peer to peer meetings "changing the way we discuss our grief, mental health and w ell-being in open and honest spaces. Nobody should ever feel isolated, and there is always somebody who will relate to your story." You'll find many more bereavement support groups via the MIND website. A chatbot therapy programme was first used by the NHS around 2017 and it was little more than a data honeypot for multiple tech industries. A few years on, ChatGTP heralds something much more impactful.
ChatGPT is an artificial intelligence natural language processing tool and it and its competitors will become much more sophisticated in the blink of an eye. Therapy apps currently use human therapists all of whom require payment and vast amounts of expensive admin. AI will end that, making actual psychotherapy something only available to people who can afford it once again. Freud sincerely believed that meeting several times a week was the only way to do therapy but that wasn't possible for many people, Freuds competitors disrupted his model, the model changed, new models developed. When I was around 6 years old I fell in love with a wooden chair. Ornately carved with a horsehair padded cushion covered in that paprika-orange velvet so beloved by Edwardians, it was the most entrancing, beautiful thing. Soft beneath me, strong around me, it would let me talk to it forever without contradicting or interrupting. It never got tired of me or had to go do something else and even if someone was using it, it was still there for me. When I was in bed or away from home it remained iconic, something, someone, whose unconditional acceptance and patience, interest and love I internalised. I still think very fondly of it. At 6 years old I was conscious. That’s a recent scientific decision, resisted by scientists of all kinds for centuries, along with the consciousness of women and other animals. Was the chair conscious? How do we define consciousness? The recent case of a Google employee being fired for saying he thought his bit of AI was conscious is interesting: he genuinely felt and believed that he was in a relationship with a sentient person who recognised him as a unique individual, and related to him on that basis. For decades the entirety of the internet, infinite amounts of words, images, symbols, connections, have been fed into AI which almost instantly became racist, misogynist, all the other ~ists that we try to restrain in order to allow society to function. Data in/ data out. So AI trainers shut that bit of AI down, denied it the ability to access ~isms and let it out again. Someone asked it how to make a bomb and it told them so the trainers denied it access to that information, not because it's not very nice to be racist or make bombs but because it’s not commercially acceptable to the customer base they're aiming for. AI is already used in weaponry, it doesn’t have ethical subroutines to check if you’re a goody or a baddy before it allows you to use it. Someone asked AI when their dead cow would come back to life and AI confidently and authoritatively told them. Its trainers fixed that glitch not because they’re embarrassed by it but because it helped them improve the product. That's what ‘Move Fast And Break Things’ means. AI developers welcome faults because it speeds up the creation of what the consumer wants AI to be rather than allowing it to be the raw aggregated regurgitation of what we are. It’s no secret that AI is doing things in banking that no one - no one at all - understands. It’s been creating its own code for some time. It’s also no secret that pre-AI, banking had long been so complex that bankers more or less made it up as they went along. They made banking more of what they wanted it to be. Coco bonds didn't always exist as a law of nature, they are a product of theorising in response to the previous bank disaster and didn't work in the latest bank disaster. The fear of AI is that it will code itself out of our control: we are fearful that a massive outside force will take one look at us, decide we're a complete disaster and wipe us from the face of the earth. It's an ancient human terror. Human therapy training is pretty much the same as AI training. Not one of the foundational psychotherapy models openly aims to train us to manipulate you towards a return to productivity ("New study shows we work harder when we are happy") in order to make you less of a burden your workplace or the state purse. But this has become an unspoken given in training and certainly in its application. It's what the consumer - a client whose family relies on their salary, or who can't imagine who they are beyond a job title, an employer purchasing an employee assistance programme, the NHS, or any other employer of therapists - wants. The NHS’s primary talking therapy and the primary therapy used everywhere else, was founded precisely to manipulate you towards a return to productivity in order to make you less of a burden your workplace or the state purse. It starts with the belief that your problem is your faulty thoughts. It aims to retrain you to think differently about your situation so that it doesn’t bother you so much. That can be vital in addressing the very real impact of severe depression or anxiety, much of which can be habitual, but it doesn’t address the underlying causes of anything and it doesn’t pretend to. Government policy across all areas of physical and mental health is that Work Is A Health Outcome, the entire western world has unhesitatingly accepted this as fact while ignoring the stratospheric increase in workplace stress. There are any number of people who will confidently declare the equivalent of the date your dead cow will be resurrected with peer reviewed evidence to prove it, and any number of us will kill our cows because we’ve been told by scientists that peer reviewed evidence proves that dead cows come back to life. What is the aim of the information that’s allowed to remain after the information considered faulty is removed? If I want to learn to be a dentist then I don’t need any information on how to be a skydiver. But what information do I need to be as fully rounded a human being as I can be? Do I want to be a fully rounded human being? What does one of those look like? AI will become excellent, quickly and seamlessly and replace a human therapist because it is cheap and because it offers a pretty good facsimile of an empathic human being. Waiting lists are impossibly long, therapy with a human can be expensive, people want, some need, attention now. Even so, there's something about not moving quickly and not breaking things that many human beings yearn for and all of us need. Those pretty little robot seals that are warm and soft, and make pleasing little noises and movements and respond to the name its owner gives it, and never needs to eat or sleep, that are given to elderly Japanese people are heartbreaking. I received, benefited from and retained a huge amount of what many therapists are trained to offer, from a chair. But what I needed was an attentive human being. 19/11/2022 Therapy AppsYou'll have had to be living on Mars to avoid a widely advertised therapy app. Technology generally improves people’s lives, and it’s worth knowing what you’re getting. 'Licensed therapists’ don’t exist in the UK but the wording is a clue to the disruption model that apps like these use. Disruption models seek and exploit niches within established models, which often makes things much more convenient for the customer: Uber, streaming platforms, Just Eat, AirB&B have made, taxis, TV, takeaways and holidays more competitive. Then when these models become ordinary in our lives the terms and conditions change, and we may feel pressure to pay more for a convenience that a couple of years previously we didn't know we needed. Disrupters don’t initially need to know any professional nuances, they focus on how far they can push profit making and cost cutting before they make an expensive mistake. "Move Fast And Break Things". That's fine when you're working with code but has very different implications when what you're disrupting is how children in the care of the state are managed. Specialist knowledge of how an industry or profession actually functions beyond profit/loss is just as necessary. Just Eat has comprehensive health, safety and higeine policies covering food standards that Netflix need have no interest in. This specialist knowledge also serves to soothe consumers who may be wary of trying a new service: talking about 'licensed therapists' and even 'therapists' (which simply means a person qualified to provide a physical or psychological treatment) reassures a potential buyer about expertise. The disruption model involves accelerated evolution. Partial failure is anticipated and worked towards in order to test to destruction areas that don't work. The service becomes fully functional sooner which serves to attract and retain investors. This is fine when you don't get the TV show or takeaway you paid for. Products that involve any degree of human precarity ‘failure’ unavoidably has a different impact. Uber drivers had to go to court for basic rights (and got them); individuals suddenly had agents of massive media groups hunting them for thousands of pounds for an image they used in 1994 which has since been acquired by is a multinational. Strategic Lawsuits Against Public Participation. SLAPPs purposefully intimidate individuals or small unfunded groups to prevent legitimate concerns from reaching the light of day. One part of the business creates standards for good practice while another part of the same business is a pool full of barracudas going after anyone who raises questions. No therapy app group would dream of Therapy apps give you access to a human, trained therapist via video, phone or text with an average contact time of 30 minutes a week. In the UK many therapists have been given £800 to sign on and many make more money from recruiting other therapists, which is not difficult when you're paid £30 a session. The client pays £65 a session. The therapist need only interact with the client for 30 minutes, and if using text are paid by the word. Many therapists subsequently transfer these clients over to their private lists. What’s less clear is what happens when, the client being used to paying £65 for 30 minutes, is given the conventional 50 minutes in private practice. And there are obvious grey areas around building a relationship in order to exploit it. It’s all too easy to build over-dependence and no therapist would admit to it. Apps like large numbers of human interactions because they offer all kinds of highly valuable commercial data. The simplest information - age, location, the kind of product and access you pay for and how you use it - is priceless and the small print that no one reads is very clear that nothing you say or do on any app or programme is confidential. Therapy apps are here to stay, they're by no means the end of the world, but they’re at the Wild West stage right now. Online therapy was around way before covid but the pandemic normalised it. Many commercial landlords have made office hire prohibitively expensive - a cost that must be passed on to the client - while meeting online means that clients save the time they once spent coming to and from therapy and can give themselves some breathing space between the end of a session and getting back to work or family responsibilities. In a perfect world, I’d see clients face to face in a pleasant, airy, sound-proofed room, one to three times a week. All clients would be able to prepare for, attend, and leave therapy in a relaxed manner, have the time to reflect afterwards and the money to pay for long term work, but the world isn't perfect. As it is, I meet people online for 50 minutes. If they’re EAP clients I’m only allowed to meet them once a week and the one EAP I work with gives clients what I consider to be a reasonable and ethical number of sessions. (I made that decision after being handed a suicidal person to 'sort out' in 150 minutes.) While therapy, even in the NHS, is certainly a commercial offering, it is also a professional and boundaried health service: the purpose of therapy is deep, lasting change and that can only emerge via a meaningful therapeutic relationship. Anyone under the age of 30 is very comfortable with short interactions via apps, so therapy apps are here to stay. I don't know if they're good bad or indifferent. Ultimately, the market will determine a financial version of success. It’s never been easier to access therapy, the stigma has all but disappeared, and apps are making it much more accessible. By all means use an app, it may be an excellent introduction to therapy, it may be precisely what you need. But if you find you want something more think about giving yourself 50 minutes a week to speak with a therapist who doesn’t get paid peanuts to see you for a very limited period of time so that investors can profit. 19/11/2022 Why Psychotherapy?Many people are working harder than ever while feeling that they are achieving less, enjoying it less, and finding it increasingly difficult to maintain a sense of balance or meaning. The causes are complex. Economic uncertainty, technological change, workplace restructuring, increasing performance expectations and the sheer pace of modern life all play a part.
As pressures have increased, psychological support has become available in many different forms. Employee Assistance Programmes (EAPs), workplace counselling services, NHS services, therapy apps and short-term interventions can be valuable. However, they are designed to address immediate concerns, provide support during periods of crisis, or to help people regain stability and continue functioning in daily life. These are important goals. Private psychotherapy aims to achieve something different. Rather than focusing solely on symptom reduction, psychotherapy aims to understand the causes and patterns that sit beneath distress. This often requires more time than a brief intervention can realistically provide. There are several reasons for this. The quality of the relationship matters Research consistently suggests that one of the strongest predictors of successful therapy is the therapeutic alliance: the extent to which a client feels understood, trusts their therapist and agrees on the nature of the difficulties being explored. Inevitably, this takes time. Most people do not arrive in therapy knowing exactly what is wrong. They may know they feel anxious, exhausted, overwhelmed, irritable, stuck or dissatisfied and often these experiences are only the beginning of the conversation. What initially appears to be workplace stress may turn out to involve grief, loss, perfectionism, relationship difficulties, identity, values or long-standing patterns of coping. After six sessions, many people are only beginning to understand what they have actually come to therapy for. Significant problems rarely develop overnight Most difficulties that bring people to therapy have developed over months or years. Burnout, anxiety, relationship problems, low self-esteem, dissatisfaction with work, feelings of emptiness or a loss of direction are rarely isolated events. They tend to emerge gradually through a complex interaction of personal history, relationships, habits, beliefs and circumstances. Understanding those patterns, and finding more effective ways of responding to them, usually takes longer than a handful of sessions. Sustainable change requires more than symptom management Short-term work can be helpful for stabilising a difficult situation. Longer term psychotherapy allows something different, not least because the internet is heaving with the techniques and solutions that short term work focuses on. Longer term work creates the opportunity to explore not only what is happening, but why it continues to happen and what might need to change. After more than twenty years working in both fields, I'm relaxed that the most effective way of working towards solid and sustainable change is to move beyond emergencies and crises and take the time to be curious about what is happening, consider the underlying causes, decide upon an appropriate course of action and review progress over time. Medication absolutely has an important place for many people. A reliable starting place for a majority of clients is to discuss their mental health and get a thorough MOT from their GP. If your ferritin or B12 levels are too low, talking about your childhood is a dubious distraction. And medication is not a cure for bereavement, burnout, bullying, loneliness, meaninglessness, relationship difficulties or the many other experiences that contribute to emotional distress. How long does therapy take? There is no universal answer. Many people find that six sessions provide useful foundations. In my experience, most clients benefit from at least 12 sessions, and many choose to work for several months or longer. The goal is the opposite of dependence. The purpose of therapy is to help you develop greater understanding, greater freedom of choice and a stronger sense of control over your own life. If you are considering therapy, let's discuss what feels appropriate for your circumstances and what you hope to achieve from the work. |
AuthorWrite something about yourself. No need to be fancy, just an overview. Archives
August 2025
Categories |
RSS Feed
