Psychotherapy

Meeting- Fiona Mcalister Counsellor Islington London

Introduction to Therapy with Fiona

I describe myself as a relational trauma-informed integrative psychotherapist.  That’s a lot of words, so what do they all mean?

  • Relational – that I aim to create an environment in which a relationship of trust develops between myself and my client which is itself a conduit for healing.
  • Trauma-informed – that I pay attention to working safely with people who are living with the impact of trauma.
  • Integrative – that I blend together concepts and techniques from different modalities I have found therapeutically effective and helpful, adapting my approach to meet each person’s specific needs.

Areas I work with

I work with individuals (adults of all ages) across a broad range of areas (see below). I specialise in working in-depth with survivors of trauma. This includes people coping with the impact of sexual abuse, parental neglect, dysfunctional families and struggling to understand the impact of their trauma on the dynamics of their relationships. Additionally, I bring a trauma-informed approach to supporting clients seeking to prepare for and / or make sense of a psychedelic experience (also called plant medicines). I am also interested in exploring the feminine and masculine; how women and men connect to and express their identities through the different stages of their lives.

“The therapist must strive to create a new therapy for each client.” *

Irvin Yalom

  • Anger
  • Anxiety, fear, panic attacks
  • Bereavement, loss and grief
  • Emotional abuse
  • Exploring femininity and masculinity
  • Family dynamics
  • Growing older
  • Low self-esteem / negative self-beliefs
  • Parenting issues
  • Preparation and integration of plant medicine experiences
  • Relationship dynamics, breakdown and divorce
  • Search for life’s purpose / meaning
  • Self-harm
  • Sexual abuse
  • Shame
  • Spirituality
  • Stress
  • Suicidal ideation
  • Trauma (episodic and developmental)
  • Women’s issues (including pregnancy and birth, menopause)
  • Work related issues (including career coaching, work-related stress, redundancy)

Therapeutic Approaches

Foundations

You are the expert on you, even if you feel you do not yet understand or fully know yourself.  Therefore, my role is to support you to find out about yourself – sharing the story of your past and how that has influenced who you are in the present, discovering your different parts, unmasking your core true self, tuning into and accepting the wisdom in your body.

Underpinning my approach are the person-centred values  of empathy, congruence and unconditional positive regard. I maintain a mindful presence to act as witness and container as you explain and explore your story.  At times, I may be more interactive, offering challenges to long-held but possibly unhelpful beliefs and open questions which suggest new ways of framing those beliefs; I might highlight behaviour patterns that could be keeping you stuck or blocking growth; and offer suggestions and tips for change.  You are welcome to act on my suggestions or decline if they are not helpful to you.

I believe that love is an integral part of the therapeutic relationship. This may sound unusual; however, the Ancient Greek description of agape and philautia embody my meaning. Agape – a selfless, universal love, unconditional, full of compassion and empathy, is the love that the therapist seeks to give to the client during therapy. Philautia – a love for self that enables us to feel confident, resilient, worthy, valuable, is the love that clients can learn to feel about themselves through the therapy. By showing my belief in you, I create an environment for you to feel validated and discover self-love.

What is trauma?

When we experience a traumatic event, environment or interaction, we might become traumatised in body, mind and spirit in the absence of a restorative counteraction. Our body can develop physical symptoms of trauma in circumstances when we are unable to take an affirmative action in response to the presence of threat, such as fighting or running away – instead the energy of our anger or fear becomes trapped in our body. After the threat has passed, we might continue to feel unsafe in the absence of loved ones, parents, family, friends to help us cathartically process our reaction to the situation, through soothing hugs, empathetic listening, simply giving us space to cry and shake out the fear.

“trauma…is…the imprint left by the [traumatic] experience on mind, brain and body. It changes…our very capacity to think…For real change to take place, the body needs to learn that the danger has passed and to live in the reality of the present.” *

Bessel van der Kolk

What is trauma-informed therapy?

The aim of trauma-informed therapy is to help us finally recognise and release this trapped energy. To regain a sense of internal safety, a deep inner feeling of being safe and held and connected. There are some essential elements needed for trauma-informed therapy to work at its best:

  • The person being ready to do the work – coming to terms with trauma can be tough, so it is wise to start therapy only when you feel ready
  • The therapist’s creation of a safe environment – as the trust develops between us, the work begins
  • A strong working alliance and collaboration between therapist and client – I aim to empower you by offering information about trauma, your options to find the therapeutic approach right for you and ensuring you have an active role in your therapy
  • Knowing that your body and mind are connected – trauma is held within the mind-body system and so I invite you to be aware of both your thoughts / beliefs and your internal physical experience
  • You do not have to tell me the story of your trauma – it is not necessary to describe what actually happened to you for us to start processing the impact of the trauma
Preparation and integration of plant medicine experiences

Experiences with psychedelics (plant medicines) can release emotions, physical sensations and insights that expand our awareness of what usually lies out of consciousness – indeed Stanislav Grof described them as “unspecific amplifiers” as they can shake loose the “deep unconscious contents of the psyche and make them available for conscious processing.” *

Whether it is your first journey or you are an experienced psychonaut, however, sometimes this feels too powerful and bewildering to process and contain on your own. I am experienced with working with non-ordinary states of consciousness such as holotropic breathwork, meditation and plant medicines and will walk alongside you before and after your psychedelic experience to support you to:

  • Prepare for your journey by exploring your hopes and fears, becoming familiar with considerations and techniques to minimise harm to you and optimise positive benefits during the journey
  • Set an intention as your inner guide
  • Explore and integrate what your plant medicine experiences have revealed, understanding how to digest that knowledge into who you are and who you want to be
  • Identifying and processing any emotional, physical and / or spiritual releases from your experience

Please note that, as the use of pychedelics is currently illegal in the UK, I cannot provide access to the substances or carry out illegal pychedelic assisted therapy. My practice does not support or encourage the use of illicit substances in unregulated and illegal frameworks.

Mindfulness

Mindfulness is a state of being that is a quintessential part of various approaches I use in therapy, such as somatic work, visualisations, breathwork. Mindfulness is the practice of bringing our awareness to our inner experience moment by moment – our thoughts, our feelings, our physical sensations. We ask ourselves two questions – “What is happening inside me right now? And can I be with this, can I let be?” Using this approach and always with your agreement, I may invite you to close your eyes and guide you to explore with curiosity your inner experience; learning about the physical sensations in your body; learning to name and begin to tolerate emotions that come up; noticing the patterns and transitory nature of thoughts in your mind. I may guide you through visualisations to find safety in your body. And I will suggest resources and practitioners  that may support you to continue these practices between therapy sessions and after we have finished therapy together.

Somatic awareness

I use somatic work as I believe that, as mind and body are connected, what happens to you in your life is stored not only in your mind but also in your body. When what we are discussing raises sensations in your body, I may guide you to mindfully focus on these underlying physical sensations. This will reveal information held in your body – the trauma of painful memories and emotions supressed by your body’s survival system. You may experience emotional release. You will develop more awareness of your body and how sensations can give you vital information about how you are, what you feel, what you believe. You can explore how your body holds stress and realise that your body’s responses are a normal reaction to feelings of unsafety. You can begin to become more connected to your body and yourself, to recover from symptoms of trauma such as dissociation or anxiety.

I may also suggest physical movements that can help you process and release trauma from your body; introduce you to gentle or vigorous breath practices to help regulate your nervous system; and give you some basic information about our body’s survival and safety system – the brain, the autonomic nervous system, the flight / fright / freeze continuum, the window of tolerance, and resources for doing your own research.

Cognitive behaviour therapy

Known as CBT, this approach explores the link between physical sensations, feelings, thoughts and behaviours to help the client better understand the reasons for their actions. This understanding enables us to make changes to thoughts and behaviours that are no longer helpful or may even be harmful.

In therapy, we might challenge stuck thoughts and beliefs by examining the evidence for such beliefs – where scant evidence exists, you are freed to find new beliefs.

You might keep a journal of incidents, detailing the sensations, emotions and thoughts that led up to behaviours you wish to change – we can then deconstruct these incidents together to illuminate unhelpful patterns; on the basis of this information, we can then design new ways of behaving for you to experiment with outside of therapy to see if the new behaviours are more beneficial. You will need to practice these new skills outside of therapy to ensure they take root.

I also link in somatic work to help clients investigate how their inner experience of sensations impacts on their thoughts and behaviours.

Compassion focused therapy

Compassion focused therapy is about incorporating the concept and habits of compassion into therapy to help you learn to feel compassionate towards yourself – to develop healthy self-compassion.

Developing self-compassion has many benefits, including counteracting the corrosive influence of our inner critical voice, reducing stress and anxiety, and developing our empathy towards self and others to improve our relationships.

“Therapy is transformative when we take the experience of being okay to be us, and being acceptable, and being valued and heard, and then we apply that to ourselves: when we start treating ourselves as the therapist treats us.” *

Carolyn Spring

Inner parts / child work

Most of us are familiar with feeling that we have different ‘parts’ of self or internal voices in dialogue within us, eg ‘part of me would like do this, but another part feels unsure’. These inner parts can be imagined as fleshed out characters of our inner voices and also felt somatically within our bodies. One part that is familiar to many of us is our inner critic; some of us also have quieter and more fragile voices that we may ignore as we intuitively understand that they represent some lost hurt part of ourselves which is too painful to embrace.

As we work, you will take the time and space to get to know your parts and voices with compassionate and loving attention. By valuing and listening to all these parts of you, you can find a way to help wounded parts let go of the burdens they carry, freeing them up to become sources of inspiration, strength, joy, and liberating the core self.

In particular, the therapy may focus on your inner child, often the most wounded part of us that needs our compassion and understanding – that may need to be reparented by you in order to heal.

Psychodynamic

How we act in the world is often influenced by beliefs we have learned through our past but of which we remain unconscious. For example, if we have experienced neglect in our childhood, we might have an unconscious belief that we are not worth loving. This unconscious belief might cause us to develop strategies to attract love, such as perfectionism or disregarding our own boundaries in our attempts to please others. Or it might cause us to become isolated and develop a bruising inner critic.

An aim of the psychodynamic approach is to bring these unconscious beliefs into your awareness by exploring how your current beliefs and behaviours are influenced by your past relationships and environments. We might explore your relationship with your early caregivers and attachment patterns, identify needs that were unmet in childhood and what this means for your adult self, and what it means to be a ‘good enough’  human in the world.

It is also useful to reflect on the relationship between us – how people react to their perception of the therapist will often give clues to how they build relationships with people in general.

Psychoeducation

I believe in the fundamental power of information. When we understand that our experience which seems so singular to us is in fact shared by many people, we no longer feel alone – we are validated, our experience is normalised, we feel seen.

And so, as we work together, I will describe and explain the different modalities we agree to use together, as well as share information about mental health and wellbeing that I have learned over the course of my life and training. If you wish, I may also suggest other resources that you might find useful to continue your own research and learning. You are free to make use of or disregard any information I provide.

Getting Started

Now that you have found out a little about how I work, if you would like to explore starting therapy with me, please contact me to find out more.

NB Throughout the above text, I have used hyperlinks to other websites and articles to enhance your understanding. In doing so, I do not claim to practice in all the ways described within the articles, or endorse the content of these websites or some of their assumptions (eg I do not believe that mental and emotional distress are ‘disorders’ or subscribe to the ‘treatment’ philosophy of therapy). Also please be advised that some of these websites are created by non-UK based organisations and include mention of processes not found in the UK (such as the American insurance-based healthcare system).

Quotes *

Yalom, I. (2002) The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients. London: Paitkus.

van der Kolk, B. (2014) The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. London: Penguin Group.

Grof, S. (cited Hofmann A. 2005 LSD: My Problem Child. California: MAPS.)

Spring, C. (2019) Podcast #6: The Therapeutic Relationship