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Why Guilt Can Be So Difficult to Let Go Of in Psychotherapy – Part 1
Guilt is a fairly common presenting problem in individual psychotherapy. Some patients come to psychotherapy because they are unable to manage a persistent feeling that they have done something wrong. They may feel responsible for hurting a husband, wife or partner, disappointing their children, neglecting a family member, behaving badly at work or causing difficulties…
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What Long-Term Psychological Change Actually Looks Like in Psychotherapy
One of the most common expectations people have when they begin psychotherapy is that psychological change will happen quickly. Many hope that after several sessions they will feel noticeably different, their distress will disappear, and the problems that brought them into therapy will have been resolved. Although meaningful improvements can sometimes occur relatively early, genuine…
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Why Emotional Patterns Persist for Years in Psychotherapy
Many people enter psychotherapy asking the same question: “Why do I keep reacting in the same way, even when I know it isn’t helping me?” They may recognise that certain situations repeatedly lead to anxiety, conflict, emotional withdrawal, guilt, self-criticism or relationship difficulties. They often understand intellectually that these reactions are causing problems, yet they…
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Repetition and the Compulsion to Repeat in Psychotherapy
Memory has fascinated physicians, neurologists, psychiatrists and psychoanalysts for centuries. Long before modern neuroscience was able to examine the living brain, clinicians were trying to understand what memory actually is, how it develops, why some memories remain vivid throughout life while others disappear, and why certain experiences seem to return repeatedly despite a person’s efforts…
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Why Certain Memories Return Repeatedly in Psychotherapy
Memory has fascinated physicians, neurologists, psychiatrists and psychoanalysts for centuries. Long before modern neuroscience was able to examine the living brain, clinicians were trying to understand what memory actually is, how it develops, why some memories remain vivid throughout life while others disappear, and why certain experiences seem to return repeatedly despite a person’s efforts…
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What Silence Can Mean in Psychotherapy
Silence is one of the most misunderstood aspects of psychotherapy. Many people imagine a therapist sitting quietly while the patient talks, or long periods where nothing is said. Some wonder whether silence means that the therapist has nothing to contribute, while others worry that they are expected to keep talking simply to fill the empty…
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How Trauma Appears in Psychotherapy
When most people hear the word trauma, they immediately think of war, serious accidents, violence or other catastrophic events. These experiences undoubtedly have the capacity to leave profound psychological scars. However, psychotherapy shows us that trauma is far more complex than the event itself. Two people may live through the same experience yet emerge with…
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How Obsessive-Compulsive Disorder (OCD) Manifests in Psychotherapy
Obsessive-Compulsive Disorder (OCD) is one of the more complex psychological conditions encountered in mental health practice. Although many people associate OCD with repeated handwashing, checking locks or arranging objects in a particular order, these behaviours represent only one part of a much broader psychological picture. OCD exists on a spectrum, varies considerably from one person…
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Further Observations on Autism in Psychotherapy: A Psychodynamic Perspective
In my previous article, How Autism Manifests in Psychotherapy: A Psychodynamic Perspective, I explored many of the psychological characteristics that may emerge when working psychodynamically with autistic adults. The aim was not to provide a diagnostic guide, but to consider how autism presents within the therapeutic relationship and how psychotherapy can help individuals understand themselves…
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How ASD and Autism Manifest in Psychotherapy
During the past decade, our understanding of autism has changed considerably. What was once regarded as a relatively uncommon developmental condition associated primarily with significant communication difficulties is now recognised as a much broader spectrum of presentations. This change has transformed not only the way autism is diagnosed but also the reasons why many people…