Psychotherapy & Counselling -
|8th December 2016|
Counsellor, Consultant, PsychotherapistHi, and thanks for checking out my site. This page will tell you about me and my work and how to get in touch if you want to schedule an appointment or find out more. The next page, "About Psychotherapy," will tell you about the techniques that I use including my own Attachment Centered Therapy. "Qualifications," the third page, is my vita, as it does seem appropriate to let you know what my training and experience has been. Finally comes "Frequently Asked Questions" which is information that I thought many of you might want to know. Again, thanks for checking out my site, and let me know if I can help you.
I am a member of the UKCP (UK Council for Psychotherapy) and certified by them as an Integrative Psychotherapist through the Metanoia Institute. Please see the qualifications page for a full listing of training, qualifications, and experience.
I providing counselling, consulting, and psychotherapy services for addictions, co-dependency, relationships, family of origin, issues of trauma, abuse or neglect, developmental and personality problems, lifestyle development, personal growth and development and other life issues.
My practice is in Manchester and London at 10 Harley Street by appointment only.
Please feel free to contact me if you would like more information or to arrange an appointment.
Healing the Broken Bond: how attachment difficulties cause problems and what to do about it
I am also writing a book about attachment difficulties and Attachment Centred Therapy. I am posting excerpts from the book below, so please feel free to read it and if you have questions or comments please let me know using the email link. Thanks.
This installment is Maslow's Hierarchy of Needs as Modified by me. As this section is very long I am presenting it in two parts. Here is the second part.
Please read below to find out more.
Areas of Specialization
Chemical DependencyI have worked in addiction treatment since 1988. I began my treatment experience working with chemical addictions, such as alcoholism, cocaine, marijuana, narcotics, prescription drugs and other drugs of addiction.
I have extensive training and experience in treating these problems, and I served on the board of directors of the Alabama Alcohol and Drug Abuse Association.
I have been certified as a Masters Level Addiction Professional, a Certified Criminal Justice Addictions Professional, and I was certified by the International Counseling and Reciprocity Consortium.
These certifications are not current, as I found that I just had too many certifications to keep up with them all, especially now that I am concentrating my work and training in Attachment.
Sexual Addiction CounsellingNext I moved into treating sexual addiction in 1992 when I entered private practice. I also treat relationship or romance addiction (sometimes referred to as "love addiction").
I have trained extensively with Dr. Patrick Carnes, acknowledged by many to be the leading researcher and writer in the field of sex and relationship addiction. I was a Certified Sex Addiction Therapist and a supervisor for counselors seeking certification.
I also served on the Advisory Board for Certified Sex Addiction Therapists, and am a past board member of the National Council on Sexual Addiction and Compulsivity (now known as the Society for the Advancement of Sexual Health).
Relationship, Couples and Marriage and Family CounsellingWe have long known that addiction is a family illness. Most people who develop problems with addictions come from families where addiction or co-addiction is present. In addition, the addiction has a grave impact on families where it is present.
It quickly became apparent to me that a knowledge of family dynamics and the best skills available for couples and family work were an important part of the recovery process. Many relationships survive the addiction only to fall apart during recovery.
I have trained with Dr. John Gottmann, the leading researcher in the U.S. in the field of marriage, relationship, and family counselling. I have worked with several systemic family therapy supervisors and participated in a systemic family therapy supervision group with Dr Don Brown in Birmingham Alabama for about 5 years. Thus my couples and family work is informed by Systemic Family Therapy.
In addition to doing therapy with addicts and their relations in recovery, I also provide marriage and family and couples counselling to others who do not have problems with addictions.
Co-dependency counsellingMany people who grow up in dysfunctional or addictive families become what we call "co-dependent". That is, they are excessively dependent on others for their own sense of self worth, or they compulsively caretake others, often getting into dysfunctional relationships that either they can't get out of, or if they do, they soon find another dysfunctional relationship to take it's place.
Because much of my work is done with people in later stage recovery when co-dependency issues begin to emerge, this field became a natural outgrowth of the other work that I do.
Eating DisordersWhile I do not deal with these problems primarily, I have seen many clients who have had these issues since addicts often have more than one addiction to deal with.
Attachment Centered TherapyThese days my work is centered on attachment. The reason for this is that I believe there is convincing evidence that almost all of the above problems stem from disruptions in attachment in childhood, and sometimes later years. For this reason I have undertaken to educate myself regarding attachment. To that end I have read hundreds of articles and books about attachment theory and research. I'm even working on a book of my own about it.
I have trained with Dr. Patricia Crittenden, who was trained by Mary Ainsworth, who was trained by John Bowlby, the originator of Attachment Theory. Dr. Crittenden has created the Dynamic Maturational Method of attachment analysis. You may visit her website to learn more about this.
I use the Adult Attachment Interview as a way to get started in therapy. This assessment provides a dynamic and revealing way to quickly identify what went wrong and why, and also immediately begins to provide the healing necessary to fix it.
Healing the Broken Bond: how attachment difficulties lead to problems and what to do about itAffiliation and Belonging
I have yielded to the temptation to rename this level. I had thought that two changes already are enough. Indulge me though while I explain the rationale for that final temptation.
The best definition of love that I have ever come across is Scott Peck’s in The Road Less Travelled. His definition of love is being willing to extend yourself [take a risk] for the spiritual growth of yourself or others. On the other hand Maslow seems to be using the term, at this level, to mean the affiliations that bind us to others in various ways that could be called affinity, affection, care, identity, possessiveness and so on. Certainly those are aspects of what we usually call love.
As we have also seen the term ‘love’ is often used to describe what I will propose needs to be called ‘limerence’ as per Dorothy Tennov’s ground breaking book Love and Limerence. We will discuss what this means elsewhere, I think. The point is, it is easy to ‘fall in love’ in the limerent sense, but much harder to build a lasting bond of love and affection that deepens over time.
Also we have the common and universal use of the term ‘love’ in a sense that has nothing to do with the romantic ‘love’ associated with limerence. Thus: ‘Greater love hath no man than to give up his life for his country;’ ‘For God so loved the world that he gave his only begotten Son that whosoever should believe on him will not perish but have everlasting life;’ etc. These two expressions of ‘love’, if we can accept that is what they are, then belong in the Self-Transcendent level of Maslow’s Hierarchy Modified.
I won’t go on with this, other than to say that the subject deserves a book of its own, and this one isn’t going to be it.
The essence of the Love and Belonging level is affiliation, or identity, where we begin to identify and affiliate ourselves with others not on the basis of biological kinship or banding together to avoid a common threat, as in safety and security, but rather for the long term benefit that will come to us via this affiliation. hence I am suggesting that a more appropriate name for this level is ‘Affiliation and Belonging.’ Certainly one can argue that this term would apply to the essence of a family identity, including one formed by marriage, and that is definitely a part of it. But please remember that we can have that at the nurtural level where a man and woman or same sex partners combine for the purpose of nurturing one another in a variety of ways, including sexual. So we can have that without ever getting to this 4th level of identity and belonging. Indeed, the illusion of ‘love’ described as limerence by Tennov is often reflected in popular and classical songs and stories, where lovers are certain that they have found the love of their lives only to be bitterly disappointed in the months to come to the extent that they think they are now living with a stranger, or an enemy, someone they don’t really know and who certainly doesn’t have their best interest at heart. Enough with that, let’s get back to Affiliation and Belonging.
At this level we are beyond the Safety and Security need and we are forming a sense of community. It is no longer facing a threat together, but rather realizing that by banding together and cooperating we can benefit ourselves more than by competing and fighting against one another.
It is out of the need for Safety and Security that love and belonging emerge. And, interestingly, it is out of trade that love and belonging emerges. As one who grew up in the radical environment of the 1960’s, with all our mistrust of business establishments and so on, the idea that trade might play a role in promoting, even establishing, love and belonging as a level of need seemed foreign to me. More important, as one who identified “love” with a feeling state called “limerence” which will be discussed at length in a later chapter, this idea was challenging to my world view. It may be to yours as well. But as I examined it more and more, it began to make sense.
There is actually much evidence to support this idea. We may begin with the examination that Will Durant gives the subject in his encyclopaedic, The Story of Civilization: Part I. Durant explores the evolution of civilization, from tribal societies to agriculture, and explores the role that trade played in the formation of alliances, civilization and culture. Even during the wars in which the Dutch were fighting for their survival with the French, the English were frustrated by the continuing insistence that they continue to carry on trade with the French, their enemies. (footnote here, Marlborough) And during World War II the Swiss carried on trade with the Nazis, grudgingly condoned by the Allies (footnote, The Swiss, the Gold and the Nazis).
In another interesting and exciting book, The Northwest Passage, the author, George Malcolm Thompson, tells the tales of many European explorers, Frobisher, Parry, Ross, and Amundsen. Throughout is the theme of initial mistrust, suspicion, and conflict as the two cultures – European and Eskimo – encountered one another. Gradually trust was built and mutual exchanges occurred. The Eskimos wanted wood and metals and other goods that the Europeans brought. The Eskimos in turn showed the Europeans how to survive and make shelters on the ice and snow:
In 1903, Roald Amundsen, the bane of several British explorers, began his ultimately successful attempt to find the North-West Passage. Though successful in the sense of actually sailing from the Atlantic to the Pacific, it proved to be a Pyrrhic victory in that the passage was of no actual use to the shipping and trade interests who financed the various attempts to discover it. However, as the various attempts were made, relations overall with the indigenous population, the Eskimos, had improved demonstrably. This can perhaps best be attributed to the change in attitude of the explorers themselves and in the regard in which the Eskimos had come to hold the explorers. Each side had learned from the other:
“…[The Europeans] had learnt to make snow huts, Eskimo fashion, and had discovered that Eskimo winter clothes were better than European and that an igloo was warmer than a tent. With the fur next to the skin, there was more room for the air to circulate.
“By that time they had met the local Eskimos and the first approach was cautions on both sides. At the critical moment Amundsen told his army [of seven!] to throw down their weapons. The Eskimo did likewise and a friendship, wary at first, and later warm and confident, grew up between these amiable savages and their alarming visitors. It was seventy-two years since white men had come to these parts under the command of Sir James Clark Ross. But the Eskimos had passed down the story of that extraordinary event from father to son. Now, just when that earlier visit was passing into legend and before it took wing into the realms of mythology, the white strangers had returned! The Eskimos asked Amundsen if their tribe could settle about his camp.” P.256
As the summer of 1905 wore on, Amundsen decided that the time had come to move on. …The Eskimos received priceless gifts like empty tins and odd pieces of wood. A spare sledge was given to a family with a crippled son whom for years his parents had dragged about on a sealskin. The young man, who was reputed to be a sorcerer, gave Amundsen his magic brow-band of deerskin in gratitude.” P.258
And with that closing example of how we advance from the safety and security level to the level of Affiliation and belonging, we shall leave the Arctic explorers and the Eskimos behind, they having served their purpose to illustrate for us the ambivalent attitude that can prevail as groups encounter one another, in their case in the wild, struggling for survival, and either become enemies or friends. What is important to recognize is that over time, friendship, or affiliation and belonging, prevailed.
We can see from the above examples that this creation of community is based on trade, which essentially means giving of value from one to another. So perhaps this level needs to be called ‘Value and Belonging.’ Regardless, the point is that we have moved from the level of conflict and uniting to meet conflict with conflict, to cooperation and helping one another mutually whether it be through trade or communalism. Either way it is cooperation and an identity of interest.
What value means is that we are able to create value by the work that we do. Thus, I might make a painting that has little value to me but greater value to you because I can make a hundred of them and you can’t make any. On the other hand you can make a ratchet wrench and I have no idea how it is done. So if I desire a ratchet wrench and you desire a painting then we have the potential to make a trade that benefits us both. And this brings us to the next level of Esteem.
Esteem of Self and Others
Our esteem is based on what we do, the purpose we serve. I imagine that all of us serve some important purpose in life. The problem is being able to appreciate it. Hence we must start with esteem of self.
This is essentially how we feel about ourselves. This is one of the key things programmed into us by our earliest attachment experiences. We also learn how to feel about and relate to others, and this guides our interactions with others that we encounter, and especially with those who are our attachment figures or candidates for same. We also, as we grow and use our first two rules for interacting with the world, develop a model of the world that guides us in getting our needs met. And finally, we learn through these interactions how to nurture ourselves and others.
So here is how that might work. I am born to a mother who has too many mouths to feed, has her own unresolved attachment issues, and is married, or affiliated, with a man who is a bit of a ne’er do well. As I result, I learn through my interactions with her that I am not worth very much, but on the other hand if I can do enough to attract her attention then she is effusive and loving toward me. I learn various manipulative strategies in order to coerce or cajole others into helping me meet my needs. I find a gang on the streets and become affiliated with them. This provides me with a sense of identity and safety that I have not felt before. I become very good at dealing drugs and become valued in the gang for my street smarts. Other gangs begin to fear me and know better than to mess with us. We soon dominate the drug trade in our area and I dominate the gang. Soon we are an international cartel. Despite the money, that is not enough. I dream of becoming a respected leader of the world, and I know that the only way that I can do that is by seizing control of the government in the country where I live and that we dominate. My dream is to set up a narco-state and use this trade and the natural resources of my country, that I can dominate more and more by our use of violence to intimidate the leaders of the country. I envision our world dominance growing out of this in much the same way that England came to dominate the world through the profits of the opium trade. I am eventually hunted down and killed on the streets of Rio by the drug agents of the world powers who fear my power.
Oh well. I suppose that just goes to show that self-transcendence can happen to anyone. But back to esteem. We may not approve of the above character’s values and methods, but at least he felt good about himself. On the other hand, consider the oncologist, world renowned, who was one of the leading authorities in the world on treating certain difficult forms of cancer. In spite of this, he felt very bad about himself. Because of the nature of the work, his patients often died. He couldn’t deal with the grieving relatives and so let a junior associate do that part of the work. He resorted to drugs – mostly the alcohol drug – in order to medicate his feelings of inadequacy about himself. After about a year or a year and a half of therapy he said to me one day:
You know, it’s funny, but after doing this work, I notice that I am able to relate to my clients and their relatives better. I really feel for them, and when I lose a patient, the first thing that I want to do is console the family. And it helps me, too, to feel better about what I do.
You may take what you like from that story. What I take is that people who don’t feel good about themselves – who don’t esteem themselves – are going to feel hollow and empty inside no matter what manner of good things others may say and think about them. And so they often resort to some kind of adaptive behaviour that is not good for them or others, such as addictive disorders, mood disorders, dysfunctional relationships, personality disorders. It is important that people feel good about themselves and what they do.
I have worked with many clients to help them feel better about what they do by seeing how what they do benefits others. It is through service to others that we gain good feelings about ourselves and those we help about us. This can be through our work, our community service, our family relationships, our relationships with family, our friends, our spiritual pursuits, and our citizenship. All of these various realms of being create value for ourselves or others, and in many cases contribute to our spiritual growth, thus fitting within our definition of love.
So my painting begins to be recognized as desirable by others. You could paint your own shield or hall, but you can make a trade with me and I can do one for you that will be much better than what you could do for yourself. And perhaps your ratchet wrenches have become famed for their durability and operation through your craftsmanship. We each in our own realm establish a reputation for our work and so people of whom we have never heard come to us seeking our services. In this way we begin to contribute to a larger group of people far beyond our affiliation and belonging group.
As we go higher in the hierarchy we begin to affect more and more people. Thus we have progressed from the individual survival level, to the mating level involving one significant other, to the family and tribal level, to the community at large, and now we are at a level that begins to transcend these local and personal contacts into the realm of the world at large, and this brings us to the level of self-actualization.
Maslow wanted to name this level with a more spiritual name, but he was concerned that the psychological establishment of the time, with its emphasis on counting and quantifying, would reject a more spiritual notion, so he borrowed a term from [who? Find out], ‘self-actualization,’ which essentially means being all that you can be. Maslow used examples such as Jesus, Martin Luther King, Abraham Lincoln, Mahatma Ghandi, and if he were alive today I suppose he would include Nelson Mandela. These people all became self-actualized and by doing so they reached a world wide audience and following. The idea is that we are all striving for self-actualization as a way to evolve spiritually. Not everyone agrees with this idea, of course. And I suspect most people don’t think in these terms, but it is a very useful way of approaching life. It is at the self-actualizing level that we seek to live by our goals and values. We promote those ideals that we hold dear. Few of us will achieve complete self-actualization, but that doesn’t mean that we shouldn’t try.
I picked up a saying somewhere that I heard attributed to e.e. cummings, though I have been unable to find a reliable reference for this source. The saying is, ‘It takes a lot of courage to grow up and become who you really are.’ Maybe this is changing, but to me it means that, in order to become who we really are we have to overcome all of the conditioning, programming and prejudices that we learned when we were young, and as we grow to begin to evolve and reprogram our minds so that we are able to make use of our full potential by service to others.
Inevitably this means taking a hard road, rather than the easy one. For the people listed above as examples of self-actualization, their ideas were controversial to the point of challenging an established order of how the world ought to work. In many cases this stance will challenge all of our other relationships. Some who esteemed us highly might fall out and repudiate us and our values because they are so contrary to cherished beliefs. Our own family and friends might distance themselves from us. This could include our mates if the challenge is strong enough. It might even subject us to punishment, imprisonment, or even death itself, as all of our examples experienced. And this leads us to the final level, self-transcendence.
At this level people become willing to risk their lives in the pursuit of their ideals. It doesn’t necessarily require this, but it often does. Self-transcendence means that we have transcended, or gone beyond, the self. It is a universal spirit kind of thing. The idea that there are as many ways to God (translate as you will – I like self-realization, or perhaps simply ‘reality’: what is) as there are souls in being, and there is only one way. This means that even though we each have our own identity, our own perceptions, memories, feelings and thoughts, that we are really all one being or consciousness that is universal. This is the level that meditation seeks to achieve, ‘Satchidinanda:’ knowledge, existence, bliss. The ‘knowledge’ referred to here is not book learning. According to the yogis the only true knowledge is that acquired by direct experience, and that direct experience comes only during those moments of Samadhi achieved through meditation. True knowledge, universal knowledge, comes only through the soul, spirit, super-conscious mind, or however you prefer to think of it. It does not come through the 5 senses (although if we add Porges’ ‘neuroception’ it should be ‘the 6 senses’). Rather it comes through the connection of our own spirit, mind or soul, as you prefer, with the universal spirit/mind/soul. If there is such a thing.
Interestingly, soldiers often experience this level in battle. Perhaps it is that because their individual existence is so threatened, some part of our mind elevates us to a level that makes that, if not desirable, at least acceptable as an alternative way of living and perhaps dying, so that one’s life is compromised in order to benefit the lives of others. And also ironically they often begin to develop a sense of identity with their enemies, the very people who they are trying to kill and who are trying to kill them. I have already referenced some of the examples of this from literature, but one only needs to watch a history channel documentary about World War Two or from Vietnam, where former enemies meet and develop a sense of camaraderie with their enemies with whom they share similar traumatic memories.
Maslow posited a psychology about this ideal. It is today known as ‘Trans-personal Psychology,’ and of course the emphasis is on this sense of identity with our spiritual selves. However he did not go so far as to posit this as a separate level of need, but I am doing so here, for the reasons already given. As this spiritual realm is somewhat ineffable, I shall say no more about it here. There is a saying that those who say do not know and those who know do not say. I think that simply means that it is impossible to describe the state of Samadhi with any degree of accuracy, and so when you have experienced it, the best thing to do is simply to report its existence to others rather than to try to describe it.
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