People come to psychotherapy with very different difficulties. Some are struggling with anxiety, depression, trauma, loss or relationship problems. Others have been trying to manage something for years: a recurring pattern in relationships, difficulties with attachment, a persistent sense that something is wrong, or a feeling that their life has somehow become disconnected from what matters to them.

Sometimes the difficulty is relatively clear. Sometimes it is not.

I do not think it is enough simply to identify a symptom or diagnosis and then apply a treatment to it. The same difficulty can have very different origins, and the same diagnosis can mean very different things for different people. Understanding what is happening — how a difficulty developed, what maintains it, what role relationships and circumstances play, and what you are trying to change — is an important part of deciding what kind of help is likely to be useful.

Sometimes that means very focused, short-term psychotherapy. Sometimes it means deeper and longer-term work. Sometimes another form of help is more appropriate.

Understand what is happening before deciding what needs to change…

My training is in Integrative Psychotherapy and Existential Analysis, and my approach has developed continually in the last three decades of clinical work.

I work with the person rather than treating a diagnosis as though it should determine the treatment.

This means looking at the different facets of your experience: your history, relationships and attachment, emotions, body, habits and patterns of behaviour, ways of thinking, beliefs and assumptions, values and circumstances.

Sometimes what appears to be a problem in one area is connected to something quite different on a deeper level. Anxiety may have roots in trauma, relationships, loss, chronic stress, and the ways you have learned to cope and protect yourself. Difficulties in relationships may involve the ways in which you now respond to other people based on what has happened to you in previous relationships. A persistent sense of dissatisfaction may, for example, have something to do with how you have adapted your life to expectations that you have never consciously examined.

Psychotherapy’s purpose is not to produce an elaborate explanation of you. It is to understand enough of what is happening to know what warrants your greater attention.

Human difficulties do not exist separately from the person who experiences them.

We become who we are through relationships, attachment, family, culture, education, adversity and the circumstances in which we live. We acquire ways of protecting ourselves, seeking approval, managing fear, defending against uncomfortable truths, avoiding rejection and making sense of other people. What was once an adaptation can eventually become a self-defeating pattern.

Part of psychotherapy can therefore involve looking honestly at who you have become, including aspects of yourself that are difficult to recognise or accept.

Human beings are capable of love, generosity, courage, loyalty and compassion. We are also capable of envy, resentment, dishonesty, disloyalty, selfishness, control and cruelty. We do not become psychologically healthier by pretending that only the more acceptable parts of ourselves exist.

This is why authenticity is so important: it requires more than learning to cheer up or be positive! It first requires that you become more honest about who you actually are.

Much of what troubles us happens between people.

You may find yourself repeatedly gravitating toward similar relationships, struggling to trust, becoming overly responsible for other people, people-pleasing, withdrawing from intimacy, becoming controlling or blaming, or tolerating things that you know are not acceptable.

Early relationships and attachment can have a powerful influence, but they do not provide a complete explanation for everything that happens later in life.

Psychotherapy can help you understand both what other people have done to you, and what you bring to your relationships yourself.

These are not always equal things. Sometimes another person has genuinely harmed you, and the first priority is protection. Sometimes a relationship dynamic is recreated partly through your own habits, responses and reactions. Sometimes both are true.

But understanding your contribution to relationships does not mean taking responsibility for somebody else's abuse.

Trauma can affect much more than the memory of what happened. It can influence how you experience yourself, your body, emotions and relationships, and the ways in which you respond to threat, intimacy, conflict, the unfamiliar and the uncertain.

Complex trauma can become woven into personality, attachment and everyday life rather than remaining connected to one clearly identifiable event.

Trauma psychotherapy therefore involves more than managing symptoms. It can involve understanding what happened, how you adapted to it, what those adaptations achieved at the time, and why some of them may no longer be serving you now.

The work may be focused and practical, or it may eventually lead into deeper psychotherapy. The appropriate approach depends on the person rather than on the word trauma alone.

We do not exist in isolation from the world around us.

Family, culture, work, social expectations, economic circumstances, relationships and wider events all influence and shape how we understand ourselves and what we believe is possible.

Sometimes psychological difficulty is largely within us. Sometimes it is substantially relational. Sometimes the wider circumstances in which someone is living really are harmful.

Psychotherapy should not begin with the assumption that the individual is always the source of the problem.

Nor does recognising the influence of circumstances mean that we have no responsibility or freedom to choose our responses.

Part of the work can be learning to distinguish what needs to be changed, what needs to be accepted, what needs to be resisted, what needs to be grieved and let go, and what remains within your power to choose.

Authenticity is one of the central principles running through my approach.

I do not mean simply being yourself. We can be sincere and still be destructive. We can also become so accustomed to meeting the expectations of other people that we no longer know which parts of our lives genuinely belong to us.

We all absorb assumptions about what it means to be successful, acceptable, desirable, normal or worthwhile. Some of these assumptions are useful. Some may not be.

Psychotherapy can provide an opportunity to examine what you have inherited, what you have chosen, what you have rejected, and what you may have been avoiding.

Existential Analysis is concerned not only with how we adapt to our circumstances, but also with whether the life we are living is genuinely our own, driven by our own needs and conscience.

Authenticity is not perfection. It is a more honest relationship with the person you actually are, the life you have actually lived, and the choices that remain available to you.

I have worked as a psychotherapist for nearly three decades, including ten years full-time as a psychotherapist in NHS primary and tertiary mental health services.

This has included work with anxiety, depression, panic, bereavement and relationship difficulties, as well as more serious and enduring problems including bipolar disorder, OCD, major depression, personality disorders, schizophrenia, PTSD, eating disorders and the effects of serious trauma and abuse.

I have also worked extensively in private practice with trauma, complex trauma, longstanding psychological difficulties, attachment and relationship problems, identity, loss and persistent emotional difficulties.

My psychotherapy training extended over more than six years. I hold Master's degrees in Integrative Psychotherapy and Existential Psychotherapy, both awarded Distinction.

What this experience has taught me above all is that psychological difficulties rarely fit neatly into categories, and that understanding the individual person over time is often more important than deciding too quickly which category or technique applies to their apparent symptoms.

You don’t need to arrive with a diagnosis or a clear explanation of what is wrong.

You may be looking for help with a particular problem, or you may have been struggling with something much more vague for a long time, despite appearing to function reasonably well.

You may have had previous therapy and feel that something important remained unresolved. You may be looking for more than advice, reassurance or a collection of techniques.

This work is likely to be most useful if you are willing to look carefully at your own experience, and beyond the surface, including things that may be uncomfortable, and to take an active part in understanding what happens in your therapy.

You don’t need to know in advance what the answer is. You need only be willing to investigate the question.

The first step is to book an Introductory Meeting.

This is an opportunity to talk about what is happening, what has brought you to psychotherapy, what you would like to understand or change, and whether working together seems appropriate.

There is no expectation that you will commit to psychotherapy simply because you have an introductory meeting. We both first have to feel able to relate to and understand one another.

If I think another form of help would be more appropriate, I will tell you.

If what I offer does seem appropriate, we can then consider what kind of work is likely to be most useful for you.

Understand what is happening before deciding what needs to change…

☞ You can arrange an Introductory Meeting by clicking on the APPOINTMENTS button