Therapeutic values and options

Put simply, mentalizing is the act of putting ourselves in someone else’s shoes and trying to get curious about their perspective, whilst recognising the limits of our ability to know what is going on in other people’s minds. Our capacity to mentalize flexibly can be affected by our early attachment relationships, as well as our current relationships and stresses- there is a saying that “when stress goes up, mentalizing goes down” (a bit like a see-saw).

Do you ever come out of an argument with your partner, child or boss and think “that all happened in a fog- I can’t even really remember what happened, and I don’t even know what I was feeling”? Mentalizing approaches can help us to slow down and get curious about what’s in our own minds, as well as what’s in our children’s minds. It can help us to regulate our emotions, understand ourselves and others, reduce conflict, decrease misunderstandings and improve communication. Deceptively simple, but deceptively powerful too. Mentalization Based Therapy was founded by Professor Peter Fonagy, and adapted for parents by Dr Sheila Redfern.

Don’t be put off or confused by the name! NVR is the main model of parenting I draw from, but the name can confuse parents- it might make more sense to think of it as ‘Peaceful Parenting’.

NVR was first developed for parents of children who showed violent and aggressive behaviours but I believe its tools to be helpful for almost every parent of teenagers. It draws inspiration from non-violent forms of protest in political history, and suggests that when teenagers act out and parents take a punitive or escalatory approach, this can inadvertently make things worse.

NVR takes as a baseline assumption that parents need to self-care and require support in order to parent well, so it begins by exploring the barriers to this. It then provides a whole range of useful parenting ideas, theories and tools including ideas around de-escalating conflict, taking a firm and consistent (but peaceful and non-violent stand against challenging behaviour) and repairing ruptures through reconciliation gestures.

Can you tell that I’m a fan?! If you work with me, it’s likely that you’ll hear more about NVR, which was founded by Haim Omer.

Emotion Focused Coaching is another parenting approach that has a prominent place in my parenting toolbox. Founded by Dr Adele LaFrance, it was again founded for a specific purpose (to help parents of young people with eating disorders set firm but validating boundaries) but it offers a truly invaluable set of communication tools that I believe has the power to really shift all relationships for the better.

Essentially, EFC helps parents validate their child’s emotions effectively, so that their children feel heard, understood and listened to. This is a core building block for good relationships, and a really essential tool for setting boundaries or having difficult conversations too. It also dovetails well with both Non-Violent Resistance and Mentalization Based Approaches.

I have tried not to overwhelm with too much information, so these are just a sample of some of the models and parenting programmes I draw from in my work, but I am happy to explain more and signpost you to books, podcasts and other resources if we work together.

Compassion Focused Therapy (CFT) was pioneered by Professor Paul Gilbert, a British Psychologist who was inspired by ideas in Eastern philosophies, especially Buddhism, and it also integrates ideas from neuroscientific research and evolutionary theory. CFT posits that if we can show ourselves kindness, understanding and support when we experience difficult feelings or physical sensations we can learn to soothe our nervous systems rather than inadvertently triggering a cascade of stress hormones that could make the original physical sensation worse. 

We cannot learn when we are spiralling with shame. Being kind to ourselves is not the same as letting ourselves off the hook; it is about soothing ourselves and creating the nurturing conditions from which we can grow into our best selves.

ACT differs from Cognitive Behavioural Therapy (CBT) in that ACT therapists do not believe that faulty thoughts cause psychological distress. Instead, they suggest that tricky thoughts are normal, and that it is how we relate to our inner experience- and that of our child- that really matters. If we can be mindful enough to notice that a thought is just a thought and it not necessarily true or powerful, we can experience it in a different way.

ACT also takes a pragmatic approach to life and argues that ‘happiness’ is a fleeting emotion rather than an attainable permanent state. Instead of pursuing good feelings, ACT directs us to cultivate a life that is meaningful and rewarding. ACT can help us to clarify the values that matter to us in parenting in life so that we can start experiencing more purpose, meaning and vitality.

Whilst I don't always agree with the theory of knowledge on which Cognitive Behavioural Therapy (CBT) was originally based, as I think it can be a bit blaming and can ignore people's contexts, it is still one of the 'gold standard' evidence-based psychological therapies and it offers a wealth of valuable tools and ideas.

CBT can help us to challenge some of the understandable but slightly irrational thoughts that pop into our minds when we are feeling under par- for example, what is the evidence against the thought that “it’s too late, I can never fix my relationship with my son now”?. It can also equip us to reframe our unhelpful beliefs, pace ourselves and gradually build activities into our routine that can boost mood by injecting us with a daily dose of pleasure, connection and accomplishment. 

Systemic therapy is in some ways an best understood in terms of what it is not, and it is especially different from psychiatric medicine. Rather than locating problems inside people and diagnosing them as mentally ill, systemic therapists locate problems outside of people; in their relationships, family systems, communities and cultures. It emphasises how contexts such as gender, race, culture, disability and politics shape us for better and for worse.

As psychologist Dr Sanah Asan has written, "if a plant was wilting we wouldn't diagnose it with 'plant-wilting syndrome'". Instead, we'd look at its conditions, its unmet needs and the context in which it is struggling to thrive.

Narrative therapy suggests that as humans, the stories we tell about ourselves and our children, and the stories other people tell about us, are not trivial; instead, they matter to our sense of wellbeing and our identities. Similar to systemic approaches, narrative therapists 'externalise' problems and emphasise the innumerable strengths people have within themselves that they may not even realise exist.

Narrative therapy would seek to deconstruct some of the stories and beliefs we may be holding about ourselves such as the story that "I am a bad parent" or the stories other people might tell about us such that we are "attention seekers". It seeks to uncover hidden 'plots' and narratives that connect us to more hopeful, strengths-based perspectives about both ourselves and our children.

Behavioural change is hard, and yet it is vital if we are to improve our wellbeing and relationships. We may need to have difficult conversations, take risks that make us feel awkward or exposed or push against our instincts to create new patterns and possibilities.

Motivational Interviewing is a respectful, empathic and gentle way of guiding clients towards behavioural change through exploring ambivalence, validating fears, connecting to values, inspiring through visualisation and supporting clients to see the 'bigger picture' of any important changes they are struggling to make in both parenting and life.