Cathie O'Brien  

  Gestalt Psychotherapy, Supervision, OD Consultancy, Coaching, and Training 

Psychotherapy

Deciding to have therapy can be quite frightening, for some people, and many people believe they will be judged by others or that it must mean there is something seriously wrong with them. This is a social stigma and the worry of how it may effect work or how they are viewed by work colleagues, friends and family is very difficult to manage - adding further  stress. Seeking therapy does not mean you are 'mad' or 'losing your marbles' and it takes a very brave person to seek help from someone else, to discuss their issues and explore how they can find equilibrium again. Life events tend to trigger all sorts of emotion and reaction and it is usually your nervous system in relation to your thoughts and feelings that has lost its balance. In its simplest terms, therapy re-balances the conflict between your thoughts, feelings and nervous system and this is generally done through talking - helping you to become more aware of unconscious processes, your senses, your feelings and what they mean. This process can help to integrate your different states into a functioning whole, alleviating anxiety and blocks that prevent you from achieving your personal goals in life. This is called self-regulation.

For some people, this imbalance started from a very young age due to the individual enduring, regular, traumatic events and for others it may have been triggered by a sudden traumatic or upsetting event.

What is therapy?

Therapy is talked about in many different ways depending on the model of work someone is trained in. Most therapists have a core training, mine is Gestalt Therapy, with other trainings as an add on to their main qualification. I hold a Masters Degree in Gestalt Therapy with a special interest in Attachment and Trauma theory and practice, please see my publications regarding this.

Amount and Types of sessions:

Short Term Focused:

  • Short term therapy can be 6 to 12 sessions and is usually focused on a particular issue. Gestalt Therapy lends its self very well to short term therapy. The therapist focuses on how you are feeling and thinking, and how your body is responding to any mixed signals you may have about your issue. Mixed signals between thoughts, feelings and the nervous system can lead to people feeling stuck, anxious or depressed.
  • Short term therapy is often more focused on symptom reduction rather than cause.
  • Psycho-educational: aspects of short term therapy can be educational for instance explaining what stress and anxiety is and your bodies physiological reactions to thoughts, feelings or the environment. It can also give you some techniques that you can use to reduce physical symptoms and reactions such as mindfulness techniques.

Long term Therapy:

  • Long term therapy: works well with long standing issues. The relationship between the therapist and individual becomes part of the focus, becoming aware of how an individual may adapt in relation to the other, as some peoples anxieties or problems are in relation to other people and the environment/context i.e. someone who always takes care of other peoples feelings and needs may well find themselves doing this in therapy and the therapist gently brings  this into their awareness.
  • Personal development. Some people enter into therapy for their own personal development, especially if they are training or practising as a therapist.

First meeting:

It is useful to have a think about what may suit you best in terms of long term or short term therapy and this can be discussed during the first meeting. The first meeting is an assessment process for both you and I.

1) To discuss your worries and concerns.

2) To establish if I am the right person to work with you and if I can help you based on my qualifications and experience.

3) Your own assessment of me and the environment I work in - is this right for you?

Gestalt Therapy (Adults)

Gestalt Therapy has been established for more than 70 years. Gestalt therapy is not a technique done by the therapist to the person, for instance going to the Dentist or Physiotherapist, it is a relational and collaborative process, empowering the person seeking therapy to have choices about their personal aims and goals.  Gestalt therapy works with the individual in the here and now. This means working with the past in the present moment; we all carry our past and our experiences into our present day. For instance, as someone talks about a past concern the Gestalt Therapist is interested in how this effects them 'now' and wonders how they feel 'now' as they are talking or expressing their concerns. The aim is to help the individual become more fully aware of how their thoughts, feelings and nervous system impact each other, sometimes creating  anxiety, depression or other forms of defences against the world they are living in – for instance remaining in a situation that is clearly making them unhappy.
     
This process and therapeutic way of working is recognised by the  neurosciences for its ability to enable integration of thoughts, feelings and the nervous system, developing the individual's capacity for self-regulation.
     
Gestalt Therapy works in the same way as many of the new, evidence based, therapeutic techniques used in the NHS and recommended by the NICE guidelines (National Institute of Clinical Excellence) such as:

  • Mindfulness techniques. Mindfulness helps to calm the nervous system through learning to live in the here and now - which reduces anxiety (Mindfulness and Gestalt Therapy has its roots in Buddhism as do many Yoga practices). Mindfulness is something an individual can practice on their own and develop as an everyday part of life, this is called intrapersonal therapy. 
  • DBT (Dialectical Behavioural Therapy) is an interpersonal therapy which also helps to reduce anxiety especially in relationship and develops emotion tolerance and emotion-regulation. It also draws upon mindfulness practice.
  • These techniques lend themselves well to short term focused therapies mainly delivered by NHS professionals.

Gestalt Therapy works at both an intra and interpersonal level, developing your awareness of yourself and yourself in relationship to another. This develops emotion-regulation which is a precursor to self-regulation, which people often described as a physiological change. They describe that something feels different and clients express feeling calmer, self acceptance and at peace with themselves and others, and this is not a case of mind over matter which they have to practice, this feels like a natural sense of difference, this is mainly achieved through long term therapy.

Many therapies overlap each other and work very much in the same way, but the various schools of therapy often use different terminology. 
     
However, as mentioned earlier, Gestalt Therapy is not a technique, it is a process. It is not something you can go away and practice on your own or have done to you; it is a process between you and your therapist, were the therapist helps you to become more aware of yourself, through feedback and a relational/collaborative approach. This process helps you to gain a sense of self and in so doing, overtime, calms the nervous system, aids connection with your world and the issues in your life that you wish to change, enhances relationships and also develops your autonomy while still being available for relationships. 
 

Gestalt Therapy (Children and Young People)

I am accredited as a child psychotherapist through UKCP's grand parenting route. UKCP sets the training standards for child psychotherapy courses. This process involves an extensive portfolio of years in practice working with children and young people, case studies, supervision hours, training and courses undertaken and demonstrating how you meet UKCP's training standards for child psychotherapists.

I have worked with children and young people for over 30 years firstly as a Nursery Nurse working in paediatrics, followed by Social Services  holding a variety of posts from Managing a Day Nursery to residential work, family support and leaving care team. I hold a diploma in Nursery Nursing (NNEB) and an Advanced Diploma in Child Care and Education (ADCE). I started my training as a therapist in 1997 and was a student counsellor for two years, 1999-2001, in a Child and Adolescent Mental Health Service. I qualified in 2001 and developed two school counselling services followed by CAMHS (Child and Adolescent Mental Health Service), specialising in working with children in care and leading a CAMHS team within a children's secure unit. I have undertaken further training since qualifying some of these are in Play Therapy, Attachment training, Trauma and dissociation, Suicide and self harm,.

In my private practice i work with children from the age of 11 years up. For younger children I work with parents and carers, enabling them to understand behaviours and develop ideas to help their child. Please see the parents and carers tab.

When working with children and young people there is much emphasis on the non verbal and relational aspects of human development, right brain to right brain co-regulation, through non directive play therapy techniques, the arts and other mediums to enable healthy expression and self-regulation. Parents and carers often want the young person to know why they are behaving or feeling the way they do, but children and young people do not always understand themselves or why they may behave or feel the way they do. The knowing about feelings and behaviour comes after awareness not before, leading to integration. 

I work very much in the here and now, especially with developmental trauma. The emphasis is not on recalling past memories or on catharsis, but on emotion regulation, emotion tolerance, being able to regulate emotion in relation to another and developing empowerment over their sensori motor system. This is done through sensory work, often in the form of play, bringing awareness to the senses and what they maybe communicating to the young person, developing awareness, stimulating the adaptive function/contact boundary, working towards integration of the whole child.

The manner in which I work is very dependant on age, developmental age and capacity. I usually also work very closely with parents, carers and professionals when appropriate. Please make contact to find out more or read my publications.