11/08/2025
"Brief reflections on therapy themes over this past quarter:
Morality
I see people with OCD as well as eating disorders - whether you have either -the idea of being a ‘good person’ or a ‘bad person’ crops up frequently and this fascinates me. Even the idea of ‘healthy vs unhealthy’ ‘clean or dirty’. Many people hold lots of internalised shame regarding how they come across to others.
I also find the increasingly polarising and binary nature of being online, really makes that fear more palpable and makes the fear of gaining weight or OCD compulsions much much worse.
Perfectionism within therapy
I find occasionally, in therapy, I feel a strong pull to be ‘doing something’ or ‘creating a change’ or ‘solution’ or ‘fix’ even if the client knows that therapy isn’t about being a fix, it’s a process for clients, that can be super frustrating at times - perfectionism isn’t about perfection, it’s about high expectations and criteria for others and when we don’t meet them, we can disengage. I find I have to communicate super clearly that my therapy although grounded in evidence based interventions, I’m not a skills or tools therapist. Anyone can ask ChatGPT/AI for these, but again it’s the application where AI will struggle. Our relationship is paramount and it’s important to lay out our expectations on on the table - as sometimes assumptions will make an ass out of me and you! I’m messy, imperfect and there is no such thing as perfect therapy. It’s just important we talk about it. So if I see it, I will name it with you.
Intellectualising/analysing with an absence of feeling
Again, many of my clients want rationality, certainty and control over the future, so this is where if we ‘know’ everything, then we can just make a change - but ultimately, eventually, we need to feel under that. Feeling is key. How we get there? We need to unpick layers of dissociation and titrate safety to feel."
Summer 2025 edition