Insights - Seaglass Clinical Consulting

23 November 202223 November 2022

Using the body to manage the mind

What can you do as a parent?

Is your child curious about other people, how they think and feel? If so, this is a great sign for her emotional growth.

When we’re open to thinking about other people’s motivations, we’re open to thinking about our own. We can imagine others from the inside and ourselves from the outside. We make friends and we grow our relationships. We manage misunderstandings and we learn from them. In short, we develop what is called a social sense of self.

So what happens when your social sense of self is disrupted for some reason?

This can often be caused by change: moving home, moving school, changes in the family and changes in the body. Change means uncertainty and we all have greater or lesser degrees of tolerance for feeling a bit out of control.

For many girls and women, changes and disruption can be managed without too much stress; they use these challenges to adapt and grow. For some however, their ideas about themselves start to feel shaky, even fragile; they may need a sense of certainty more than others in order to feel safe.

In some cases, thinking about the body is used to replace thinking about feelings. There’s a sense of measurable control associated with our bodies and appearances: we can weigh and measure or seek positive comments and likes. These activities can become a concrete way of evaluating yourself.

Many researchers and clinicians now agree that problems with the social self underlie many of the body issues that trouble girls and young women: disordered eating, self harm and distorted body image.

It is wonderful to take care of our bodies, to enjoy our health and strength and take pleasure in how we look. However, when we become too preoccupied with our body, it stops being enjoyable. We start withdrawing from the world instead of engaging with it. If we are overly anxious about how we look, it stops us from focusing on other people. We might not be able to manage our anxiety by enjoying our social life and confiding in our friends. We become more stuck in our own heads, so to speak.

At times when a child might feel very uncertain about her own place in the world, the body can provide this certainty. It can be hard to let go of this refuge and your child can seem perhaps too certain: rigid, driven, hard to reach.

So what can you do as a parent if you notice that your child is using her body to manage her feelings?

A targeted, gentle therapeutic approach helps: look for an in-person therapist together and bear in mind that it may be a long process while your daughter builds up trust in the relationship.

Meanwhile, how do you talk about this at home? You might have tried denying her point of view or presenting her with opposing evidence; to talk her out of what seems to be unreasonable behaviour. This is unlikely to work because she is relying on her metrics to hold herself together mentally. Other people’s attempts to take her away from this refuge of stability and certainty come to be seen as a threat rather than a support. This leads to further retreat and even a ‘doubling down’ on these behaviours.

So how do we get around this? The key word here is curiosity.

You are being curious about what is going on for her. You’re not trying to counter it. It might feel difficult or distressing to hear what your beautiful child thinks about themselves without responding. But your goal is to create a tiny sliver of light, to demonstrate that your daughter can use a little bit of space, an oasis even, in your mind to help her start to think safely about herself.

Here are some tips to consider:

Listen with your full attention. It sounds obvious, but so many of us are looking elsewhere or attending to other things when our child begins to speak. Listen in sympathetic silence; don’t interrupt them or wait for them to finish so you can jump in.
Acknowledge with a word. Just by saying a small, encouraging word (oh…mmm…I see) you invite the child to keep talking and find her own solution. For many children, the question, Why do you feel that way? shuts them down and this is especially the case when they’re using their bodies to shut down feeling.
Don’t deny the feeling. Name the feeling. If you can put a name to a child’s inner experience (you seem so angry!), she will be comforted and feel understood. It may well not work the first time; but your child is beginning to learn that she will be heard with openness, curiosity and compassion.
ALL feelings are permitted. You are not agreeing with the feelings; you are acknowledging them. By naming hatred, rage and despair when they are felt, you are teaching your daughter to trust her own mind. Exploring feelings without judgement will reduce the intensity of the emotion and prevent physical ‘acting out’; which is exactly what an overfocus on the body is. You are telling your child that ALL of her is acceptable, not just the ‘nice’ parts.

If you’re worried you’ve been unhelpful or said the ‘wrong’ thing. It doesn’t matter. Let her know later, when she is emotionally calmer, that you’ve been thinking about this and how they might feel.

Compassion is always welcome, whenever and however it comes.

[Article written for Day of the Girl 2022]

Dr Laura Henagulph, DClinPsy, MA (Oxon), BSc
Chartered Clinical Psychologist
Executive Director, Seaglass Clinical Consulting
Clinical Director, TheraTails at the SPCA

5 March 20215 March 2021

Animals: grief, loss and healing

The grief associated with the loss of a favourite pet can be overwhelming. TheraTails offers a safe space to help the healing process.

For so many of us, our animals were our only living source of warmth and love during lockdown. Screen interactions may have helped us to maintain contact with friends and family but they also reminded us that we couldn’t hug, or touch. Animals became the only providers of physical support and closeness.

Attachment to animals is a strange thing, at once simple and complex. We often value these relationships just because they are so straightforward. They aren’t clouded with moods, expectations, suspicions; pets don’t play games or cut off contact; they don’t say one thing and mean the opposite. For those of us who become overwhelmed or overstimulated by other people, animals are a respite.

But beyond the happy daily round of love and food, our mutual dependency deepens. For our animals, we are the sun, moon and stars. My cats think I can turn off the rain and they get annoyed with me when I don’t. In turn, we project our most desired qualities onto our pets (so cute! so loving!) or maybe things we don’t like so much in ourselves but can find sweet and quirky at a distance (so chunky! so anxious!).

Over time, we entwine ourselves together with our animals and they become a sort of mirror self, reflecting back our own emotions and helping us manage and contain them. For some, the unconditional regard our pets offer us is something they always wanted and never had as children. For others, animals replace a much-loved partner or parent, or hold memories of a special person. The relationship is profound; and so can be the sense of loss when an animal is gone.

Grief and Loss

Anecdotally, I had heard of the trauma around the last trip to the vets; and what psychologists call complicated grief around the death of an animal, the sense of loss that is mixed up with pain and anger and seems to endure and worsen rather than get better with time. It can seem like the emotional pain will never end.

TheraTails Support Group

I currently provide clinical oversight of TheraTails which is run in partnership with the SPCA. We have noticed that those who work and volunteer at the SPCA are often exposed to the sharp end of separation and loss. They have felt helpless and despairing both for the animals and for the humans they encounter. After discussion with my co-therapists, we decided there was a need for a group that addressed the issue of animal loss and bereavement. Like all trauma, the attitudes of those around you can reopen the wound: people are told to “just get another pet,” as if loved ones can be easily replaced; or are made to feel that their sorrow is excessive, or strange.

Through TheraTails we will be running a pilot group once a week at the SPCA, free of charge. The group will help people process and find support around experiences of losing an animal. We will also provide a one-off individual session if needed. We are open to all referrals but we hope to prioritise those who depend greatly on their animals; those who are perhaps more isolated or alone; or those who would hesitate to access therapy in the ordinary way, maybe for financial or cultural reasons.

If you are interested in learning more, for yourself or for someone you know, please contact us via Facebook or email events@spca.bm

11 September 202011 September 2020

Reflections on City

Last week, we lost a dear colleague. Our therapy horse City had to be put to sleep because his joints were too painful to carry him anymore. This wasn’t an unexpected loss as he was elderly; but he had seemed so solid to us, like he would always be there. He was an invaluable part of the therapy team because of this quality.

Despite his solidity, City was a highly sensitive animal. We came to realise that, when in ‘the ring,’ he would invariably pay attention to whoever was, in that moment, suffering the most. Normally, of course, this was a client. They came to us anxious or stressed or full of fear: City nudged and pushed his head against them until they were able to see him properly and come out of themselves.

One day, I received an unwelcome personal email seconds before the session was due to start. I took a few deep breaths and went into the paddock, my heart beating very fast. City came straight up to me and put his head on my shoulder. I was taken aback – it felt uncanny but comforting, as if the world outside had taken notice. There are many other examples from our practice: City was able to calibrate his behaviour, insistent when the client was switched off and protective and soothing when the client was stirred up.

Horses work so well therapeutically just because of these instincts. The herd is constantly shifting and hierarchies are fluid; horses pick up on subtle energies and communicate them. However, some horses cannot manage what they pick up. A client with powerful feelings will disturb them which can lead to the horse ‘acting up/out’. City was wise and experienced enough that he could absorb the client’s feelings without needing to then get rid of the energy.

This ability, to notice difficult feelings, react to them and then hold them is a key therapeutic skill. Therapists use their minds to contain what might not be bearable for others. This helps clients begin to process their emotions, but of course it can be draining work for both client and therapist. Whether human or animal, you are left with traces of trauma and suffering that you then have to separate out from your own experience.

City did this work; he was able to contain things for others. Sometimes, it left him very tired. We never explicitly asked his permission but he gave it every time he stepped willingly out into the paddock and began to notice who needed him. He carried emotional weight for our team and for the many people he helped and we thank him for it now as we did after each session. Rest in peace dear friend.

“…they have pulled our plows and borne our loads
But that free servitude still can pierce our hearts.”
The Horses, by Edwin Muir

3 July 20203 July 2020

The Biggest Bluff (Book Review)

I’ve just read this new release by Maria Konnikova. She’s a Russian-American author who specialises in accessible writing about cognitive psychology. Her last book, The Confidence Game, was about cons and scams; what makes us susceptible and how our cognitive biases can be used against us.

In her new book, Ms. Konnikova dissects the nature of chance and the role of skill using the game of poker as the crucible. After a run of misfortune in her personal life, she decided to study poker to find out exactly what she could control and what she could not.

This book has received a good deal of media attention because the author went from complete novice to tournament pro in a year, winning thousands of dollars to date.

Maria Konnikova has an appealing, confiding prose style and she weaves in complicated ideas so they become rooted in the real world. As she describes her journey, she discusses life traps like overconfidence, social conditioning, magical thinking and, most of all, the failure to pay attention. She introduces many ideas about how we perceive and process the world – the Gambler’s Fallacy, the Dunning-Kruger Effect, the locus of control – and describes the studies that back them up.

This book illustrates how one person found a way out of the narrow oubliette of her own automatic thinking. The intention is to help others do the same. This is a useful read if your imaginings about fate, or risk, or your worries about the future hold you back from making effective decisions in your everyday life.

You can find it on Amazon here.

9 June 20209 June 2020

Beyond words

The end of talking therapy for trauma?

Trauma, and its effects on our everyday life, has been receiving increased attention in the wake of COVID-19.

In the last few years there has been a fundamental reappraisal of how trauma is treated. The 2014 bestselling book, The Body Keeps the Score, argued that traumatic stress is held in the body as well as in the mind. This means that to treat trauma effectively, you need to treat it holistically.

Due to this revelation many clinical psychologists (including myself) have embarked on additional training in evidence-based embodied therapies such as Eye Movement Desensitisation and Reprogramming therapy (EMDR). This technique is then combined with more traditional trauma work, such as trauma-focused Cognitive Behavioural Therapy (CBT) in which the traumatic memories are talked about and re-framed.

But in cases where traumatic experiences have happened when the person was very young, before they could adequately symbolise it in words, this trauma can remain pre-verbal.

Trauma can even be non-verbal; so terrible that it resists language and cannot be spoken. In these cases we, as clinicians, often see the effects of trauma manifesting in the person’s everyday behaviour and in their relationships.

Transgenerational Transmission of Trauma

Another emerging area of research in this area is the transgenerational (or intergenerational) transmission of trauma and the developing field of intergenerational psychiatry.

In attempting to account for their own emotional suffering a client (with the help of their therapist) may be searching past experiences for a cause; but it seems to elude them. That it can never be fully captured in words is usually because it never directly belonged to them. Instead the pain and fear have been held in epigenetic memories and become part of family life, with the previous generations doing their best to manage the effects of this unspeakable trauma.

In cases such as these, the embodied therapies are the only effective treatment. And it is not just trauma, there are other mental health disorders that are held in the body, such as eating disorders and addictions; even those suffering from schizophrenia have been found to benefit. These disorders have a physicality about them which words and medications often cannot reach.

Animal-assisted psychotherapy and trauma

Animal-assisted psychotherapies are embodied therapies. Clients who have difficulty communicating can easily participate. The healing progresses through touch and the non-verbal alignment of emotions.

There is now a growing body of evidence within the Eagala Model for the effectiveness of equine-assisted psychotherapy in healing those who have experienced trauma. There are even entire practices dedicated to working with veterans suffering from PTSD.

The key for all trauma therapies is helping the patient symbolise their experiences. Once symbolised they can be properly ‘digested’ and then encoded as an emotionally-manageable memory. If this is successful these memories can then be retrieved, by choice, and further utilized in the never-ending development of the Self.

Talking therapies can do this effectively and they do work for many people; but not all, however. And the people for whom these approaches do not work tend to be, as always, members of society who are disenfranchised and socially disadvantaged.

This is precisely why we started TheraTails: to offer trauma treatment to those who require more specialised approaches and who often need them the most; and as they are often the least likely to be able to afford such therapies, we also thank our generous sponsors at Third Point Re, whose funding means the cost is even less!

26 April 202027 April 2020

TheraTails: Animals for therapy right here, right now

Shelters all over the world have seen a rise in animal adoptions during the COVID-19 pandemic. Why? This article outlines some of the reasons: emotional support, the need for touch and the desire to care for another creature. All of these are especially valuable when we’re in isolation. Interacting with an animal can help with anxiety, lowering your heart rate, blood pressure and cortisol levels while increasing your feel-good dopamine.

The TheraTails Program, supported by Third Point Re and run jointly by Seaglass Clinical Consulting and the Bermuda SPCA, builds on these benefits by incorporating animals into psychotherapy. We’ve seen, at first-hand, the therapeutic power of working with animals.

We combine clinical expertise with behavioural knowledge in a multidisciplinary team approach. A clinical psychologist and an animal specialist are both present throughout each session. As well as animal-assisted psychotherapy (AAP), which takes place with the dogs and cats, rabbits and rodents of the SPCA shelter, we also practice the international gold standard for Equine-Assisted Psychotherapy (EAP), the Eagala model, with our certified Eagala practitioner (read about our experiences at a recent conference here). As we use shelter animals, we can tap in to narratives of loss, abandonment, re-parenting and reparation with our clients.

What does a session look like? First of all, our clinical psychologist performs the triage and assessment in-office, and will explain to the client exactly what to expect. We then move to the shelter. The client is introduced to our co-therapist and asked to choose an animal or animals to work with – this often brings up the interesting discussions. Depending on the client’s needs, we then work with the animals actively or more mindfully.

For the more active therapies, socialising or training animals, the client experiences a sense of agency, an immediacy of connection and the buzz of collaborative achievement. In other, quieter sessions the focus is on the animal and our observations; we are all in the present, using the safe space for reflection or simply silent acceptance.

The Eagala sessions with our therapy horse are a paradox; while they sometimes seem calm and uneventful, there is a lot going on under the surface. During the Eagala sessions the team and the client have had insights that many sessions of more conventional therapy have failed to elicit; it is very a powerful catalyst.

If you would like to learn about the process in more detail, and have a look at our qualifications and training, please see our TheraTails brochure here. Now, we also have a TheraTails Instagram where we offer snapshots of how and why AAP and EAP work; and what it might feel like to experience a session.

Due to the current situation we have now started to use a telehealth approach, offering an approximate experience of being with animals however we can. We have just run our first tele-AAP sessions and have some creative ideas gleaned from our Eagala Network for the EAP. Contact us to find out more.

How about you and your pet, right now, at home? Well, there has been some interesting research about the ‘mirroring’ function of animal companions, and how closely they are identified with the self. This means that when you stroke, soothe and comfort an anxious animal, you are nurturing part of yourself. It is a cycle: as the animal relaxes, you too will experience a shift in your internal state. Being with your animal companion is an effective first step in managing and overcoming your anxiety.

19 April 202026 April 2020

Transforming Therapy through Horses: Reflections on the Eagala 20/20 Conference

Watching sessions in the arena, I was struck by the tremendous energy, both physical and emotional, that was unleashed. At first, I didn’t really grasp what was happening. There was a lot of movement among the horses, some gentle commentary and suddenly the volunteer ‘clients’ were talking excitedly, unable to contain their feelings. Something amazing had taken place.

Eagala is the global standard model for equine-assisted psychotherapy (EAP). Following a period of training, I have been providing this powerful form of therapy for a number of months, along with colleagues at the Bermuda SPCA. I work within a close-knit team which includes myself, the Equine Specialist, Kate, and our therapy horse. We have been struck by the speed and immediacy of the work. Often, I have learned more about a person in one session of EAP than I have done in weeks of talking therapy.

EAP works through projective energy. The herd are highly sensitive and attuned to humans and in turn, the humans project powerfully onto the herd. All this is mediated through the team, who gently encourage and allow the session to develop with as little interference as possible. Clients often use objects such as buckets or rods to create structures in the arena, while the team draw attention to the way humans and animals interact and perform.

At the end of February I spent three days in Lexington, Kentucky attending the 20th anniversary Eagala conference. What I saw in Kentucky were demonstration sessions, using coaching goals with volunteer clients. This was to avoid the depth and exposure of real therapeutic work. Yet in these supposedly ‘superficial’ sessions people experienced profound shifts in thinking. We watched a volunteer make a connection with one particular horse, then build a caged structure to contain her ‘goals’. The horse she had chosen persistently nudged aside her rigid barriers, freeing her ‘goals’ one by one. Equally moving was watching the fast, agitated circular movement of a group of horses suddenly stilled when the humans in the arena knelt down, reached inside themselves and quieted their own anxiety. Again, while it was striking simply to watch, it seemed that the people actually interacting with the horses were experiencing something deeply stirring.

Having witnessed EAP in action, I am even more inspired to further develop this therapy on island. If you know of someone who may benefit from this type of therapy then please contact us today to discuss further.

UPDATE: Along with our Eagala networks and trainers, we have been exploring ways of offering EAP as a telehealth option. We have attended some sessions and the modality looks promising. Again, please do get in touch if you are interested.

11 October 20196 December 2019

Burnout and the loss of the self

Millennials, gig economy workers and corporate high-flyers are all suffering from burnout, but mounting overtime is not the only culprit.

The term ‘burnout’ is fairly loose; different people make different associations. I think of it as disconnection, exhaustion and cynicism. This article begins to examine some of the factors that might contribute to this state and the feeling of being out-of-control is key. Not out-of-control in an exciting, freefall, chaos-creating kind of way; rather, the sense that you are passive, without choices. You have no agency.

Agency is an incredibly important term in positive psychology. One of the very first things we learn as children is that we can act upon the world and affect it in some way; if we push a ball or grasp a block, IT MOVES. This sounds so simple but it is the first step to seeing yourself as a separate and complete person with an identity and a will to change. If you are in a work environment where, effectively, you push and push at a ball and it never moves, it erodes your most basic sense of who you are. When that happens, you become disconnected from yourself: and you disconnect from others. The way you relate becomes rote, less satisfying, rushed and suffused with guilt and obligation rather than with pleasure.

If your attempts to shape your own workflow and output are repeatedly blocked or overruled, you stop trying. You feel resentful, and the cynicism sets in, an allowable form of low-level passive-aggressive anger that does not result in you exploding and losing your livelihood. You begin to feel useless and deskilled. You stop questioning the meaningless admin noise and begin to feel that you don’t have the ability or motivation to do very much else. Trying something different, getting out, getting interviews, just seems exhausting.

This is a crucible for feelings of low mood and anxiety. About 50 years ago, Martin Seligman proposed the theory of ‘learned helplessness‘ and depression. In attachment and mentalisation research, connection and relating is seen as the key component for mental health. Meaninglessness, the sense that nothing you do matters, is a frightening and dangerous feeling that existential psychotherapy (and most other forms of therapy!) seeks to ameliorate.

So if you are feeling fed up with your job, clock-watching, completing tasks in a desultory way and generally feeling like you don’t care, take a moment to think about agency and helplessness. It is the responsibility of the management to help you feel like you make a difference in the work world. If your company does not do this, and you think it has little capacity for change, maybe you are better out than in. It might be the first real, life-affirming decision you have taken in a long time.