Blog - Jonathan BosworthCounselling PsychologistJohannesburg

When is Therapy Over?

30/4/2013

Clients often start therapy asking how long the process will take to get them to where they want to be. The length of therapy may differ greatly depending on the patients symptoms, personality, goals, the type of therapy and several other factors. Clients may decide to end therapy because their goals have been met, they are relocating and cannot see their therapist any more, for financial reasons or because therapy brings up difficult content and feelings that the patient may feel that they do not want to deal with or are not ready to deal with (this list is by no means exhaustive).

It is important for both therapist and client to think about what it means to end therapy: has the patient's goals been met? Is the ending premature? Is the client ready to continue to work on these things by them self? Does the client need to put into practice what has been learnt in therapy? Is therapy ending because of difficult feelings between the patient and therapist? Does ending mean that important material is being avoided?

These are just a few questions that may come up when thinking about ending therapy. Most psychological difficulties will never fully be resolved and the patient may continue to work on and process things long after therapy has ended. The ultimate goal of therapy thus may be for the client to be able to become their own therapist. There are numerous factors that may equip and ready an individual to be open enough to their psyche, relationships and world to be able to continue the work of therapy. The following article provides a thought-provoking exploration of what the characteristics of a person that may be ready to end therapy are: http://www.psychologytomorrowmagazine.com/the-talking-cure-are-we-there-yet/

Perinatal Depression: The Hidden Struggle of Parenthood

24/4/2013

Pregnancy and parenthood are often constructed as times of joy and fulfilment. However, becoming a parent (for the first or numerous time/s) can be a difficult adjustment that is often fraught with change and loss. The following video highlights the importance of parents allowing themselves ways to acknowledge and process such difficulties. Change and loss that has not been dealt with may heighten the risks for perinatal depression and anxiety (including both antenatal and postnatal elements). As many as 1 in 5 mother and 1 in 10 fathers may experience postnatal depression. This may be particularly difficult for parents with the societal expectation of "parental bliss" and hence may leave parents feeling shamed and wanting to hide what they are going through. Perinatal depression and anxiety can be pervasive both for individuals and families and it extremely important for parents not to hide difficult feelings and symptoms they may be experiencing as this may delay getting help and prolong their difficulties. Perinatal depression and anxiety are not uncommon and can be effectively treated through a combination of approaches, such as medication, support groups, education and psychotherapy (parent-infant psychotherapy, individual and family interventions).

What is Intersex?

24/4/2013

What is intersex? Are 'male' and 'female' the only sexes? What defines sex: genitals, hormones, chromosomes, something else? Can you be intersex without knowing it? Is the surgical alteration of ambiguous genitalia in infancy a form genital mutilation? What is it like to be a parent of an intersex child in a gender-binary focussed society? What are some of the experiences of intersex persons?

The existence of multiple sexes has great implication for the way we conceptualise sex and gender as well as for the lived everyday experiences of 'sexed' persons. The following BBC documentary explores some of the above questions:

How Therapy Works

18/4/2013

How does therapy work? Is it more important for therapy to be scientific and evidence-based or to be something more idiosyncratic? A subjective experience that captures an individual's unique reality? A distinctive, understanding space created between therapist and client? Wellness and meaning-making beyond symptom reduction?

In the following article psychotherapist Mike O'Connell explores these questions and emphasises the significance of therapy being more than scientifically-based techniques. He also notes the benefits of having different types of psychotherapy. Furthermore he backs up his arguments with examples specific to LGBT persons.

http://www.psychologytoday.com/blog/quite-queerly/201304/be-or-be-well-how-therapy-works

The Biology of Dads

16/4/2013

Biologists and evolutionary psychologists have frequently proposed that the male strategy to get as much of one's genetic material into next the generation as possible has centred on men maximising their number of mates and minimizing their parental investment in their young. In relation to this strategy, proposed female strategies have often centred on women securing mates that will provide them with resources to raise their young. Traditional gender roles have often complied to this view of parenting in which mothers are primarily in charge of bringing up their children ("barefoot, pregnant and in the kitchen") while fathers are responsible for providing an income for their family. Gender roles, however, are constantly in flux and fathers' involvement in the parenting of their children is on the rise.

The following BBC documentary introduces some interesting research on the biological reactions fathers have to being a parent and the unique qualities that fathers bring to parenting. Some of these findings include:

A foetus responds more to its father's voice than its mother's voice
While their partners are pregnant fathers may experience dramatic hormonal changes that may bring on symptoms similar to morning sickness
Directly after the birth of their child fathers' testosterone levels may drop to the lowest they will ever be (other than before puberty)
Paternal involvement may particularly boost children's language development
The children of single fathers having been found to be more independent than the children of single mothers
The early involvement of fathers may be related to children having more self-confidence and higher academic achievement as well as a decreased probability of participating in delinquent behaviour
The different disciplinary style of fathers may be of great significance in parenting adolescents
Absent fathers may be linked to girls physically maturing faster, having earlier an sexual début and being at an increased risk for teenage pregnancy
Girls' experiences of their fathers may significantly impact of their choice of intimate partners

These findings have interesting implications on how fatherhood is constructed and in understanding the important roles that fathers may play in their children's development (especially their early development).

The Efficacy of Psychodynamic Psychotherapy

9/4/2013

Research and media coverage often focuses on the efficacy of Cognitive Behavioural Therapy (CBT). But what about other psychotherapies? Specifically what about Psychodynamic Psychotherapy? The following article in the Harvard Mental Health Letter summarises research on the merits of Psychodynamic Psychotherapy. Some of the key findings of meta-analyses mentioned were that Psychodynamic Psychotherapy is just as effective as Cogitive Behavioural Therapy with a variety of mental health disorders (such as depression, anxiety and personality disorders) and that the benefits of Psychodynamic Psychotherapy increase long after therapy has been ended. The article also provides a good introduction to what Psychodynamic Psychotherapy (including both time-limited and long-term approaches) is and what patients could expect from this type of therapy:
http://www.apsa.org/portals/1/docs/news/HarvardMentalHealthLetter092010.pdf

The Teenage Brain

8/4/2013

Adolescence is often seen as a turbulent time, especially from the perspective of parents. During the teenage years the individual goes through various social changes within their family, peer groups and culture as well as physically and emotionally. In the following video, Lisa Kudrow (yes, she was biology major!) interviews Abby Baird (a psychology professor at Vassar College in New York) about the teenage brain. Baird provides an interesting discussion about how the adolescent brain can be viewed as an adult brain in practice and how fluctuations in abilities such as decision making can be attributed to this practice. The discussion is aimed at the lay person but also deals with important - and often complex - neuropsycholology and may be a useful resource for parents, teacher and adolescents (among others) to better understand the biology underlying "typical" adolescent behaviour. Baird also makes some important points about applying with caution general findings to individuals (especially around gender) and how key it is for parents to understand their children's own idiosyncrasies.

Being a Good Enough Parent

4/4/2013

Parenting can be a challenging task by itself but with constant "DOs and DON'Ts" from family members, friends, professionals and the ever increasing media parents may feel overwhelmed, pulled in multiple (often opposing) directions and find it hard to find their own unique parenting styles. In the following article psychologist Judith Ancer provides helpful suggestions on the importance of finding a balance as well as useful practical tips on how to do this:
http://judithancer.wordpress.com/2012/10/20/the-good-enough-parent/

The Sibling Bond

2/4/2013

Psychologists have often neglected the importance of siblings - or not having siblings in the case of the only child - in an individual's development. Psychoanalytic theorists (Freud and his followers) especially have frequently rather focused on the relationship and dynamics between the child and its parents. However, some contemporary research and theory emphasises the significance of also thinking about and understanding the impact our siblings have on our personality development and the decisions we make in our lives. In the following video Jeff Kluger gives an interesting talk on "hidden power of siblings":