New Beginnings Therapy
Dr. Madalina A. I. Day
The Daily Morning: Where Peace is within
Preventative work and its importance
The Daily Morning and the Oxford Comma: where Peace is within, and always
Every morning and every day, every month and every season, and every year and every decade can be a day or everyday when one wakes up to something to look forward to. That very first thought, called daily morning, in one's mind, matters: a look towards the future, the possible, a hopeful you for a hopeful tomorrow.
15th June 2021
I had no intention on writing more for June 21 Blog - But, then again, circumstances halfway through the month called for a change; I had a few distinct encounters with risk assessments and preventative work during the past few weeks.
Risk assessments are continuous processes incorporated in any work with clients/patients. Such a process starts at assessment or initial sessions, or upon referrals from other services, and continue throughout the work. Risk assessment is a highly significant process - safeguarding the patients, whilst monitoring any fluctuations/changes in psychotherapeutic focus.
Recent work prompted me to revisit suicide prevention work as a conceptual map and rethink all my therapeutic encounters with suicide prevention , allowing for an identification of possible themes/patterns in all such narratives.
The result was writing an article for Counselling Directory that had to be simplified and much of importance had to be reformulated. The article in its entirety can be found here: https://www.counselling-directory.org.uk/memberarticles/suicide-prevention-and-anger-in-they-said-and-i-said
However, this blog is accessible to anyone with an interest in mental health practice, independently of being a potential client, service collaboration or not. It is a free space.
Main theme identified when rethinking preventative work across 8 services in both private and public practice was in fact a phrase:
"They said and I said" ... Eight services, countless patients without a distinct criteria of forming a client group except for a deeply felt uncontained anger and years of battling with mental health challenges.
Ironically, by putting forward "They said and I said" = it can be argued that it is about my practice and specific psychotherapeutic encounters - they . I am aware of that, however, client group is not a valid argument - because in the room there is not an I from a therapist/psychotherapist point of you - not in psychodynamic terms (Winnicott may want to come forth and discuss countertransference and a therapist awareness of intense feelings), in CBT terms there is only a collaboration, empirical collaboration between the therapist and the client and all other potential models would not so much acknowledge the therapeutic relationship as essence to the therapy. So the article is, as much as it can be, a professional opinion evidence base from across several services with one element in common -all such clients/patients were long term patients for over 12 months in therapy. The cases I am referring to, are extreme and I have worked with such patients for years. From different services - majority of such services offer outreach work in the community, specialist services such as personality disorders, neurodevelopmental atypical cases with extreme life trauma and many more. This article is based on all such encounters and it includes cases of onset/ clinical depression - severe psychological challenges. It is a warning really: when the talk about they and I - exists, it can mean recall of severe trauma - from a psychotherapeutic point of view. It may be that there are coping mechanisms in place, such as self developed resilience or built -in safe defenses. But in cases of clinical depression and if prescribed medication, any triggers in life situations would leave you further exposed - the appreciation of such talk is immense.
At face value may mean nothing , but in psychological terms, it is or it can be devastating.
It goes beyond that - it can be about felt discrimination and anger that can exceed humanly tolerance levels questioning identity and membership to group/ belonging; it can be about an unprocessed closure event and anger about similar experiences felt as same and or it can be about preventative psychology - even if it reads so little.
The below excerpt is what has been reformulated from the original article on Counselling Directory and I think it important:
"They said and I said and Anger.
Anger is never a feeling that can ultimately be left unaccounted for; anger is survival only when not left adrift to ravage one’s mind, because when it does, it turns onwards and against life itself. Anger is only a powerful emotion associated to living when processed and fully understood. Do not push it aside and do not ignore it, it becomes they – to start with - and then it becomes the I, with a great potential of annihilating your desire to live. The most extreme cases and the most encountered cases of such transitions are when They are distinctly different from the I - it could be through culture or any or several criteria of difference. Obstacles of culture and language are, unfortunately, some of the quickest ways of identifying and designating they - not necessarily wishfully, but it can happen when one experience discrimination perhaps not overtly felt or immediately felt. The other or combination of any other 9 protected criteria could form a distinct and clear sequence of events of they and I as notable experiences in whatever setting and format. Please think about that before you decide that mental health conditions are always primary to life experiences. Often, are not. Gender, sex, sexuality, race, can be primary felt challenging experiences in a repetitive and hurtful sense of They and I.
Developmental stages and ways of communication can play significant roles in all such events. Interpersonal potentials involved in communication, i.e., personality traits or neurodevelopmental factors are highly relevant to a they and I communication- please do take your time to fully understand yourself from whatever angle, school of thought or chosen way to do so. The world is never about they - I have learned that much. It took years of therapy to some of the patients that have worked with me, to unpack the they and reveal to themselves what they meant by they. Sometimes they representing one or two or three separate individuals or organizations at large. Sometimes all such individuals to be recognised as good and bad not only good and not only bad.
They can only exist when the "I "decides to let them exist and take over. The I and You are what really matters. YOU Matter. The dialogue between They and I can only be useful to discover you, at least in psychological, psychotherapeutic terms. And your healthy sentence could sound like: "When I used to think that there was a They and I, I later realised that there was an I and someone else saying that I was a YOU to them."