Autism.

Here at Counselling Connections one of our therapists noticed that we have a growing number of clients on the Autism spectrum.  Over snatched coffee breaks, and more relaxed lunchtimes, we remarked that the depth and richness that autistic people add to our client group is a very welcome part of our evolution as a counselling service.  This was the start of many conversations in our kitchen about the nature of Autism, why it ‘suddenly’ seems to be everywhere, and how we can best accommodate the needs of our neurodivergent community.

Some of us therapists are old enough to remember a time when Autism was considered rare, invisible and scary.  It was thought of as rare because health services weren’t very good at diagnosing it (historically Autism was exclusively associated with intellectual disabilities and profound social and behavioural difficulties). It was invisible because, shamefully, people on the spectrum were almost always institutionalised, and very deliberately excluded from society. It was thought of as scary because society had little understanding about the function of ‘odd’ autistic behaviours and sought to fearfully control and supress them, rather than meet them with love and curiosity.

Eventually, health professionals knew they had to do better than this.  Even though there remains a long way to go, the stigma that once clouded Autism is starting to disperse, and we are learning that it is a much more nuanced way of being than once thought.  It is called a spectrum for a reason, in that there is no one-size-fits-all formula that explains Autism.  However, attempts are being made to identify and explain Autism that, despite their limitations, are at least a step in the right direction.

Over the past few decades, Autism has been diagnosed using the Diagnostic and Statistical Manual of Mental Disorders Volume 5 (the DSM5, for short).  This is a dense, technical, rather medicalised manual that means well, but immediately creates problems with its very title; it universally labels Autism as a disorder that needs to be fixed.  For some, Autism clearly is a profoundly disabling disorder requiring lifelong, unremitting care.  However, for others, Autism is a unique way of experiencing a world that is not designed for those of us wired up ‘differently’; it is not the person who is the problem, but a society that fails to make space for anyone not conforming to their limited (and frankly boring) ideals.

So, while the DSM5 is better than nothing, it is troubling because it paints Autism with broad strokes that don’t apply to everyone.  It is useful as a signpost to services that clients need, but it also reduces people to a depressing set of deficits that ‘need to be corrected’.  This is not how we see things in our practice.

Here at Counselling Connections we don’t view our clients as people who need to be fixed, but as whole, struggling humans who are trying to make sense of an often incomprehensible world, whether we’re on the Autism spectrum or not.  We meet our clients where they’re at, not where society thinks they should be.

For example, we know that some people experience Autism as profoundly disabling, while for others it may manifest as anxiety-inducing social difficulties.  Some people on the spectrum have an intellectual disability, while others have doctorates and stellar careers.  Some autistics have immense difficulty engaging in the most basic human interactions, while others are married with children and enjoy a busy social life.

The breadth of manifestations of Autism can generate anxiety among well-intentioned health professionals; we worry about meeting the needs of our Autistic clients without doing harm.

Here at Counselling Connections we have a very simple solution for this.  We ask our clients what they need.  We know that if we want to learn something, the wisest source of information is always the client.

Courses, conferences and workshops are useful, but nothing teaches therapists as profoundly as the lived experiences of the people we serve.  Our philosophy is to eliminate a culture of ‘them-and-us’ and to embrace an ethos of collaboration and mutual respect.  Embracing neurodivergence as evolution, rather than a fly in the ointment of limiting western ideals, is our way forward in this crazy, beautiful world.

Here at Counselling Connections this week one question has been on our minds above any other. It’s a simple question that a colleague asked over a coffee break. The question is What is Trauma? It stopped a few of us in our tracks because, for all that we deal with trauma all the time, and we feel that we know what it is, its not that easy to define. In other words, the question became, ‘how would you define trauma simply? And we decided we’d have a go at it and share it with you, our readers.

So, if the challenge is to find a simple definition of trauma let’s begin with a simple answer: Trauma is a shock to the psyche.  We were agreed that this was a good beginning. The shock to the psyche definition mer with general approval. Then there were all kinds of additional factors to take into account.

Firstly, let’s not start getting into trying too hard here to expand on what we mean by the psyche. Some of our number could spend all day talking about differing theories of the mind and how theorists describe various functions and parts of the psyche. Interestingly, most ideas about how the mind works separate the functions of the psyche into three separate functions. Maybe that’s a whole other post.

Let’s go back to our shock definition. There are many factors which help to categorise different kinds of shocking experiences. One simple one is the shock of a single, major event. This could be, for example, a road traffic accident, a common traumatic experience. There are a number of factors here: the seriousness of the accident; injury to the self, or to others; the immediate response of other people involved. For example, if another participant in an accident reacts with anger or blame this can greatly affect the experience of the trauma for the victim.

Further considerations include the possibility of being held accountable for the accident, perhaps including the law and being charged with a motoring offence. Even to be held blameless can result in traumatic after effects. It can shake our belief in the safety of the world which we become accustomed to until it is lost in this way. Injury to ourselves or to others in a road traffic accident will cause a traumatic effect and needs a bit of work in therapy to come to terms with. This is greatly increased when an accident causes the death of another, whether that be a loved one travelling with us or to a random stranger involved in a collision.

A violent event is in the same category of major trauma. This can include when violence is directed at us personally or if we are a witness to it. Often such violence is quite senseless. An event, which we experience, often correctly, as life or death will involve a perpetrator who is in an altered state for whatever reason. When trying to come to terms with these events our minds search for meaming often where there is none and this takes a bit of working out in therapy.

Then there are a whole range of traumatic kinds of things that happen in the family home. These include the addiction of a parent to alcohol or another substance. These an often lead to chronic trauma which means that the same kinds of incident can happen repeatedly again and again over many years. Our minds react to these chronic events by making adaptions to survive the events which can affect us in later life.

Those latter kinds of traumatic events often involve being a witness to violence or arguments. Another kind of chronic trauma is when another person inflicts some kind of pain or invasive action on our body. These can include a single event, like a rape, or a series of events like the sexual abuse of a child. There are a range of adaptions that our mind makes to survive these kinds of traumatic events. These can be worked out, slowly, over time in a safe therapeutic setting.

Many factors affect the level of trauma that someone might experience as a result of these events. Past experience of trauma and past experience of loss or bereavement can resurface following even a relatively minor new event.

Theories of the mind and understandings of traumatic responses to events are well studied and understood. We have specialists here in Counselling Connections. We’d be glad to hear from you if you wanted to begin your own journey into uncovering and exploring your own experiences. We understand that, above all else, the road to healing involves having an understanding and sensitive witness to your therapeutic journey.

Counselling Connections.

Sunflowers and Cocaine.

Here at Counselling Connections this week we had one of those ad hoc chats standing around the kitchen just like the old days before the pandemic. The subject of our discussion this week, as always, is just about what is happening in front of us just now. Right now, there were two things in particular. We got into a discussion about the garden here at the office. Those of you familiar with it will know that we are lucky enough to have a long town garden, a regular oasis from the busyness of the street outside.

We have had one or two issues in the garden lately, the principal of which has been two infestations of aphids in quick succession. The weather has been consistently hot and mostly dry and in promoting good plant growth this also created perfect conditions for the greenfly to thrive. Greenfly love nothing more than fresh new green growth. They feed on the underside of new leaves sucking the sap and turning the leaf black and causing them to wilt. They have wreaked havoc on a crop of young Sunflowers we had grown from seed.

We took some remedial action and although we lost about half the sunflower plants, we managed to save the rest and they seem to have recovered well enough. As part of the same office chat, we spoke briefly again about another infestation which seems to be continuing undimmed around us. That is the proliferation of recreational drugs, cocaine in particular. And, as we do, we made the comparison between the two parts of our discussion, the sap eating infestation of greenfly and the sap eating characteristics of cocaine.

We have strong views on the harm that drugs can do. This is based on our experience of working with individuals, couples and families who have been struggling to cope with the consequences of the damage to physical and mental health and on relationships. We feel sometimes like we are swimming against the tide in our ‘say no to drugs’ point of view. It is very much the case at the moment that there is a strong view that there is no harm in a little cocaine use and that everyone is at it. We don’t agree.

One thing that we say about the whole area of addiction is that the book is already written. It is very difficult to imagine anything new can be added to the patterns of behaviour. If you are in the grips of recreational drug us, let alone full-blown addiction, you won’t come up with a brilliant new idea that someone else hasn’t tried already. Or a brilliant new excuse. It all been tried already. Denial is probably the first and most important part of the process. Denial about the drug use and denial about the harm it is causing. Lies go hand in hand with that. And those lies become corrosive to relationships and to good mental health.

We have seen many beautiful souls hurt, sometimes beyond repair, down the years through drug use. Psychotherapy literally means soul healing. We will continue to bring a little healing to souls in the face of the drug epidemic that continues beneath the pandemic. We live in hope.

The analogy, the metaphor, is with those Sunflowers we were able to save from the greenfly. Feeding them well, taking care of them, giving them exposure to sunlight and protecting them from the cold. Looking after them in this way will facilitate their blossoming with great yellow flowers. And those flowers contain the seeds which help to keep the circle of life going.

What you borrow from the day.

Here at Counselling Connections, we have been talking about addictions. As we write we are in the throes of the third wave of the global pandemic and another lockdown. This brings its own difficulties. But what we are talking about this week is a phenomenon that exists outside the bubble of the lockdowns.

We have written before about the psychology of a hangover, the graph of what happens to us in the looking forward to followed by the looking back with regret. http://www.counsellingconnections.ie/cc/psychotherapy/the-psychology-of-a-hangover/

Following on from that comes an idea about a deeper, maybe simpler view of what happens when we play with substances. Substance can be any of the usual mind-altering kind from alcohol to various recreational drugs. Even prescription medication. They all have differing characteristics.

One characteristic that lures us to take some stimulant or other is to squeeze as much high energy uninhibited fun into one night. Partying, dancing, talking, laughing are a great release. Only some of the time the excess which is such an attractive part of all this is fuelled by an excess of whatever accelerant or amplifying agent is used.

Here’s the thing. This is what we say here. What you borrow from the day, to give to the night; it has to be paid back. What we mean by this is more than just the hangover and spiritual hangover we talked about before. This is especially relevant when taking something for the high becomes a regular thing.

What happens is some sort of balance between day and night becomes disturbed. The day becomes more difficult because some of the light that you need to see you through the day has already been burned. That light was gathered together to give to the night. And It was great. But now it’s gone. You can be left feeling bereft. You can be left with no light, no energy, no life force for the day.

Having no life force for the day makes things difficult. In a situation like that we tend to withdraw. We withdraw back into ourselves, into the cave. This happens with our work. And relationships. Some of the time, once you get on this train, the only escape is the night. You can light up the night again with whatever gets you there. Maybe now it is just not as bright as it was before. The highs aren’t as high, the craic is not the same. It is harder to find the buzz. And then there is the day. The day is waiting. Empty.

What you borrow from the day, to light up the night, that has to be paid back. The balance has to be restored. This line is a well worn one. Lots of really lovely travellers have tried this track before. Lots of them have come back with stories to tell and also an appreciation for the simple life. Never taking little things for granted. A few don’t come back. In their name and in the names of the people we love who manage to restore the balance and live contented, we simply say try. Try to live well. Try to live clean try to live healthy, with healthy friends and healthy relationships. It is awful tiring to live in debt to the night. If you feel you can, reach out and come in and see if we can help you get some sort of peace of mind. If we can, we’ll always try to reach out a hand to a friend we know of who is on this path.

Further reading. If you like you could listen to Wish You Were Here by Pink Floyd while reading this post.

Christmas and New Year opening times 2020/21.

It has been a mad year. Nobody could have predicted what happened and what we have all had to endure. Beginning in March we had to shut and stay shut for nine weeks. We found ways to keep in touch, voice and video consultations. We spoke from home to people in their homes, their kitchens, bedrooms, from their cars and who had to go for a walk to be able to talk freely.

Nobody could have predicted how well it worked for many people. It wasn’t for everyone and many were glad when we were able to open our doors again and free to meet face to face. We managed this with protocols to sanitise and disinfect and come together safely as best we could. That effort involved taking responsibility which was embraced by therapists and clients alike. We feel proud at how this has worked out and are grateful to each client who took responsibility for every other client and for all of us who pass through this special place.

What we have seen this year is resilience and adaptability. It is a tribute to the human spirit to witness how people have found ways to manage all the challenges that the year has thrown their way.

This year, more than any other we have been humbled by the work, by the trust you place in us and by the value which you have placed on your therapy and your therapist. More so than ever before we found ourselves being asked ‘How are you?’. We are glad to have come through this testing time together. It is not quite over yet but we look forward with hope to the new year and an eventual return to something like normal.

So, we’re taking a few days off to revive and reset. We wish you peace and good health and look forward to working with you again in 2021 and beyond.

We’ll be here until Wednesday 23^rd of December at 6pm. We’ll be back after the break on January 4th 2021.

We are not an emergency service. We will keep an eye on the email and voicemail messages over the holiday and will be on touch to make appointments in the new year.

Thanks again,

Counselling Connections.

tel. 042 9331803 mob. 086 0381073

Christmas and New Year Holiday arrangements 2019/2020.

We’ll be open until Monday 23rdof December at 6pm. We’ll be back after the break on January 6th 2019.

We will be checking the voicemail during the days when we’re not here so if you like to leave a message we’ll ring you back to arrange an appointment. We don’t have an around the clock service for emergencies so check our links page http://www.counsellingconnections.ie/cc/links/ for contact details for Aware and Samaritans.

It has been another great year here at Counselling Connections and we remain humbled and grateful at the confidence you place in us. We’d like to wish all our clients and friends a Happy and Peaceful Christmas. We’re looking forward to working with you in the New Year.

Thanks again,

Counselling Connections.

tel. 042 9331803 mob. 086 0381073

Christmas and New Year Holiday arrangements 2018/19.

We’ll be open until Friday, December 21st at 6pm. We’ll be back after the break on January 3rd 2019.

We will be checking the voicemail during the days when we’re not here so if you like to leave a message we’ll ring you back to arrange an appointment. We don’t have an around the clock service for emergencies so check our links page http://www.counsellingconnections.ie/cc/links/ for contact details for Aware and Samaritans.

It has been another great year here at Counselling Connections and we remain humbled and grateful at the confidence you place in us. We’d like to wish all our clients and friends a Happy and Peaceful Christmas. We’re looking forward to working with you in the New Year.

Fergal and Maggie. Counselling Connections.

tel. 042 9331803 mob. 086 0381073

We’ll be open until Friday, December 22^nd at 6pm. We’ll be back after the break on January 4^th 2018.

We will be checking the voicemail during the days when we’re not here so if you like to leave a message we’ll ring you back to arrange an appointment. We don’t have an around the clock service for emergencies so check our links page http://www.counsellingconnections.ie/cc/links/ for contact details for Aware and Samaritans.

It has been another year of extraordinary work here at Counselling Connections and we remain humbled and grateful at the confidence you place in us. We’d like to wish all our clients and friends a Happy and Peaceful Christmas. We’re looking forward to working with you in the New Year.Counselling Connections.

tel. 042 9331803 mob. 086 0381073

The Irish Forum for Psychoanalytic Psychotherapy Clinical Series Spring 2016.

Mindfulness in Psychoanalytic Practice Led by Michael ( Michelo ) Del Monte.

Venue: The Teachers Club (Club na Muinteoiri), 36 Parnell Square West, Dublin 1.

Dates: Saturday: March 5th, April 16h and May 14th 2016 Time: 10.30 am – 1.00pm.

Cost : €120 (Trainees in clinical practice €90 ) for series Spaces limited – Early booking advised 7.5 CPD awarded by ICP Further information, contact: Ann Daly, tel. 01 – 2722105 amdpsy@gmail.com

Long before CBT began to embrace mindfulness, psychoanalysts were exploring Eastern philosophy and practices from a psychodynamic perspective. Freud’s instruction to both analysts and analysands regarding free association, the third hovering eye, etc. are very relevant here. These three experiential sessions will be of interest to those who wish to explore the interface between the Western psychoanalytic approach to insight and consciousness and the much older Eastern approach to mindfulness and levels of awareness . Thus, the three sessions shall be a combination of the theory, philosophy and practice of mindfulness. The theoretical aspect will be sandwiched between experiential practice. There will be ample time for discussion of the theoretical, philosophical and mindfulness practice, and its relevance to clinical and personal practice. The use of mindfulness in deep listening to the analysand will be explored in terms of transference and counter-transference, as will its role in the construction of well-being.

Michelo DelMonte is a psychoanalytic psychotherapist working in private practice in Monks town, Co. Dublin, following retirement from his post as Principal Clinical Psychologist in St. Edmundsbury Hospital, Lucan, Co. Dublin (part of St. Patrick’s Hospital). Having primary degrees in both Genetics and Psychology, his M.Sc and Ph.D. research in the Psychosomatic Unit of St. James’s Hospital Dublin focused on psycho-physiological aspects of meditation and mindfulness. Michelo’s subsequent research and writing on Eastern Practices and Western Psychology and Psychotherapy span many decades, He has contributed to publications in Europe, North America, Japan, China and Australia and has published close to a hundred articles on mindfulness from psychodynamic and existentialist perspectives.

Here at Counselling Connections this week we have been turning our attention to one of the less favourable aspects of the holiday season. Regular readers will know that we love this time of year. We like to try to remain tuned in to the cycle of the seasons and the turn of the earth. We like the ancient celebration of the solstice and the promise of brighter days to come. We love the optimism and the gathering together for a family celebration. Another feature of all of this anticipation is expressed in a letting off of steam in a series of office and other parties. A build up of months of hard work is released in group celebrations up and down the country. These occasions often involve the consumption of alcohol; sometimes lots of it. So, as we witness groups of friends and colleagues dressed in seasonal jumpers and often hopping from one pub to another in the latest party craze we pause here to reflect on what comes next. Without wishing to be accused of being party poopers, we’d like to pause for a moment and give some thoughts on the psychology of a hangover.

The first thing to bear in mind about a hangover relates to the expectation and frustration that sometimes accompanies the drinking behaviour in the first instance. People say to us that if they have had a hard week or a tough time in work that they intend to blow off a bit of steam on a Friday night. The reasons for having a few drinks can be important and we’ll explain why a little later. Sometimes clients tell us of occasions where they know that the reason they have a few drinks is to make some emotional problem go away. This is very successful in the short term but it brings a number of built in challenges with it. In short, it doesn’t last longer than the alcohol. In the best traditions of a Greek or a Shakespearian tragedy, the seeds of the eventual fall, the hangover, are sown in the character of the build up and the pressure which we’re seeking to release in the first instance.

Sometimes these pressures are emotional and sometimes mundane. From one end of the week to the other we get to bed and get up and commute and rush about at what is, to our instinctual self, often regarded as the bidding of the other. We go to work because we have to. We have to pay rent and mortgages. We have bills to pay. We don’t have as much discretionary income left over as we’d like to. And in these latitudes the evenings gradually get darker to the point where we often go to work and come home again in the dark and it can seem like we’ll never see the light of day again. The idea then of a chance to party a little, to kick up our heels and even to misbehave a little is a very welcome one. Indeed, at some level we feel we deserve a party as a reward for all our effort. This can be experienced as a frustration and a sense of entitlement for an office party where the company look after us for being good little boys and girls; we get to be naughty for one night for being good all year long.

If you’re thinking that what you’ve read so far isn’t in our usually positive tone well you’re right. That’s because we think that some of these frustrations and anger are what is expressed in a night of drinking and these are what return then with a vengeance the morning after the night before.

So, you wake up in the morning after having a little too much to drink the night before. Sometimes this is mild enough and at other times it is much more debilitating and puts you out of action or bed bound for the best part of a day. One of the first things that people describe is the phenomenon often referred to as ‘the fear’. This seems to be a double edge sword. Firstly, it is simply a feeling of all over dread based on the physiological reaction to the levels of alcohol consumed and still in our system. Alcohol is a depressant. Secondly, as we wake and review the previous evening’s activity we are often consumed with a range of feelings based on what we can remember of what we have done the night before. Sometimes this process happens in waves over the course of the day. We might have said something indiscrete or just plain stupid. We might have just carried the fun a little too far and made a nuisance of ourselves. Or we might have committed some sexual indiscretion and wonder how we can undo any damage to relationships that we have caused. A number of referrals to our office come as a result of violence, sometimes involving police and courts which were a direct result of alcohol intake. We get belligerent when we’ve had too much to drink.

As we look over these things we face the fall in our estimate of our self and can spend some time in self reproach. We call this part of the process a spiritual hangover. Quite apart from any physical sickness which will quickly pass, this spiritual part of the hangover can be quite serious and oddly enough can be part of the process of frustration we described earlier which will build and lead to the next blow out. People often describe to us how this can become a cycle which can seem difficult to escape. So, drinking heavily can cause real spiritual or psychological harm which is not good for our mental health.

The reasons why we were tempted to have a few drinks in the first place return with a hangover with a renewed self destructive cheer. It is like all the problems we were trying to escape simply sat on the sidelines and witnessed our brief interlude into a party self and then expressed themselves again with a renewed vigour. And again, this is often then associated with severe self reproach. We are hurting our self when we do this. And we tend to do it over again.

The antidote to all of this is quite simple. When we say it to people they think it is quite radical and often a little extreme. The one sure way to avoid a hangover is not to drink. When we dream of a lovely, bubbly, cold beer on a weekend we rarely pause to check our expectations or experience. The drink does not deliver on the promise; it doesn’t give us what we hope it will. It is very temporary. We don’t stop to think of the whole process of hangover and recovery that we have gone through before. Sometimes this process is harmless enough but often it is not. It is often quite harmful to the self, to our mental health, to drink to excess and then to repeat it again. We can get stuck in the cycle of this and end up feeling miserable over and again. Quite apart from any physical health problems we can say for sure that it leads to mental health problems.

So, with apologies for the sobering tone in this, the party season we would simply urge you to look humbly at your own drinking. Mind your self and take good care of your mental health.

Counselling Connections.