Friday 13 May 2016

Exam Time Again - How to cope with Exam Stress

Exam Time Again

Just as the sun begins to warm our skin exam time looms for thousands of students. Hours are to be spent huddled over books and computers and acres of notes are created. Inevitably some students just seem to work through this process but for others it is a time of stress, torment and crushing self-doubt, all of this bleeding into the life of the family.

I must confess that as a 16 year old and later taking my finals at degree level, I recall vividly vowing never to sit an exam again such was my fear.  On the night of one of my ‘O’ levels I was to be found under my parents bed weeping in sheer panic, the best solution thought to   give me the following morning some little pill from the medicine cabinet.  This of course taught me no real coping strategies and did me no favours.  Exams for most young people are a fact of their educational lives, but with a few strategies I believe they should not cause the fear and panic I myself have experienced as well as witnessed in the young people I work with and know.

One of the most rewarding aspects of being a counsellor/Hypnotherapist has been in the last month or so working with students with anticipated exam stress. They have usually have had moments of sheer panic or been communicated with in a non- productive way causing great lack of confidence. My experience has been of students caught in a system that puts a great deal of expectation of high results, from all angles; teachers, parents (no matter how laid back we may appear they want to please us)and of course themselves. There seems to be a constant highly critical and negative internal dialogue of ‘I must, get a grip, it will be the end of the world’. 

So what do we work on in clinic?  Really it is a process of putting everything into context (creating the bigger picture), turning negative self-talk into something positive and with some personal healthy coping strategies if the panic does begin to bite.

  • ·         Initially we talk about what path the student sees themselves following, their hopes and expectations for the future. Does an A grade really matter to them, or other people? Do they need it to get where they want to go? We talk about the things they love doing, the things they don’t.  Crucially we talk about what is the worst that could happen in reality? Remember Edison failed numerous times before creating the light bulb.

  • ·         Practicalities matter.  A steady revision timetable with times for breaks and rest. The breaks are nourishment for the body and soul.  Crucially we talk about the night before the exam, hopefully getting the whole family on-board and planning a stopping time for revision as well as relaxing and comforting activities that will ensure reasonable nights sleep.

  • ·         Importantly we work on breathing, a skill for life.  Basic meditation techniques are brilliant in helping the body reach a place that is calm and receptive. Just asking the student to find 10 minutes a day to sit in a quiet place and listen with a gentle awareness to the sounds around then is a simple way to start, this can be extended then to bringing gentle awareness to their breathing.  Within moments the whole body begins to relax down.

  • ·         Tina Turner had the right idea when she strutted about the stage in a red dress and high heels if I recall singing ‘simply the best, better than all the rest’.  Well you don’t have to go that far but Ms Turner is a good illustration of positive self- talk. This is also another skill for life; the ability to step back and realise we are not helping ourselves when we hear that inner voice say ‘I can’t do this’. A better strategy is to learn the habit of turning the difficult into something that helps us. One such method in this case is the creation of a little phrase (self-Affirmation) personal to the student that helps to keep them on track and motivated such as ‘I can do this, this is just one more step toward my goal’.  In clinic we often combine this affirmation with a self -soothing technique, the best one I know is to gently create a circular movement with your index finger on either the wrist of your other hand or the palm, whilst keeping your eyes fixed on an object of your choice.

  • ·         Now finally in clinic I do use Hypnosis in this situation.  Crucially and this could be done at home, we look at all the steps to taking the exam, talking about the least fearful to the most, seeing at this point if there is a more positive way of looking at the situation.  Where I differ as a counsellor and Hypnotherapist is that under hypnosis I then work with my client at a process called desensitization, gradually working through the steps and reducing the fear and replacing this with the desired states of the client; usually calm, confidence and problem solving strategies.  Projecting into the future new positive habits and ways of being.

I do hope that in some way this article helps stressed parents or students.  I know that exams, although never a completely joyful experience for the majority of us, can have the ability to stress us all to the point of exhaustion considerably reduced.

Michelle Krethlow Shaw

Saturday 19 March 2016

Don't worry be happy

Don’t Worry Be Happy

 As human beings from time to time we all find ourselves worrying over something.  You maybe the sort of person who wakes up at 5.00am ruminating over  some perceived difficulty you are facing, or just get constantly distracted during the day by some worry that just keeps churning round in your mind. One of the most discussed difficulties with clients in my clinic is rumination, that inability to just let unhelpful thoughts go.

It is often believed that being able to worry is a positive personality trait, that it aids problem solving, that if:  ‘I worry hard enough about something in the future, about which I have no real certainty of the outcome then perhaps…..’  Well exactly you can’t predict the future, that would be a unique trick. How many times has the thing you have been worrying about been completely different. For those of you with teenagers; how many hours have you spent talking through worries at school from a presentation to relationship difficulties, to be yourself on tenterhooks all day only to be brushed aside casually when they return home with a ‘oh that, yeah it was great, no worries’.  Other beliefs claim that worrying is a motivating force, that worrying protects and prepares against negative outcomes: ‘if I worry about something bad happening then at least I will be emotionally prepared when it does’. ‘Being stressed and worrying is who I am, in my job it’s the only way to get things done!’

Constant worry, Rumination and let’s include here self- criticism, keep your body’s threat (fight or flight) system alive and kicking. Welcome then the sympathetic nervous system; telling your body it needs extra adrenaline and cortisol to make your heart work faster, to feed oxygen to your muscles (in case you need to run) shut down your capacity to actually think rationally and calmly (ever frozen in an interview?) as well as restrict your ability to digest food.  Of course I simplify.  There are all levels to the body’s stress response but worry and rumination activate processes within your body that if continued for any length of time can affect not only your mental health and wellbeing (I often work with people who are just generally anxious) but also compromise your immune system leaving you open to a range physical illnesses.

Worry Busting

There are a whole range of approaches to help ease you away from rumination but above all for me it is about learning to be compassionate to oneself. That is to say endeavouring to treat yourself with kindness and understanding.  Being compassionate in fact activates the parasympathetic nervous system (putting the brakes on the threat response); one of the effects being to release the hormones oxytocin (the loved up hormone) and Vasopressin, thus helping to restore the body’s natural balance, lower blood pressure and generally create a feeling of optimism.

·         The first action is to bring into your consciousness the fact that you are worrying, even saying to yourself: ‘oh I am worrying’, then state clearly what you are worrying about. You could break this down by asking; what are my thoughts, emotions and how am I behaving?  

·         The next set of questions to ask yourself are: Is this situation in my control? Is the way I am thinking logical, if I looked at this from another person’s perspective how would it look? Is there evidence to support my thinking this way, are there facts that could help dispute your way of looking at the problem. My favourite question here is: Is worrying about this helpful or unhelpful to my wellbeing at this moment? The answer is usually no!

·         So is there anything I can do now? If yes then take action (act rather than worry) even if it means making a list of things to do tomorrow, and then put the list away. You have done all you can do.  If the answer is no, the source of the worry is beyond my control, then there are any number of ways to work with this.

You can deliberately change your thoughts or your actions to something positive; getting busy round the house, going for a brisk walk, thinking about a place where you remember feeling serene or safe.  You could also help this along by saying to yourself: ‘STOP, CANCEL, CHANGE’ and in your mind imagine, in turn a stop sign, wiping the worry away and then changing to a more positive thought (some people use an elastic band on their wrist to ping when they say stop).

Many of my clients report that writing helps.  Often setting down your worries on paper even if you don’t read them back helps to get them said and rationalised.  Once written down it is your choice what you do then; worries have been written on balloons and let go, put onto computers and deleted, safely burned, ripped up and thrown away.

Worry Time
You can give yourself allotted worry time each day, condensing your worries into a planned slot.  After a time most people come to the realization that it takes a great effort to force yourself to worry.

Mindful Meditation
Learning Mindful Meditation is a longer term solution affecting your overall health and wellbeing. Meditation is a journey of discovery, not only helping you to relax and look at the process of worrying in a new and non- judgmental way  but to gain a deep level of understanding about your own mind and body and your relationship to the world you inhabit.

 In writing this article I have put together thoughts drawn from a range of therapeutic approaches and all are used within my own practice with clients.  As ever I would welcome your thoughts and feedback.

Michelle Krethlow Shaw
Psychotherapist, Counsellor and Hypnotherapist.
March 2016

Monday 21 December 2015

A Voyage Round My Father's Ashes

A voyage with my father’s ashes

One day in June 2014 I finally ran out of parents or in the words I first spoke to my husband   ‘I have just become an orphan at 50’. Becoming your own grown up is a funny thing. Losing both your parents can be cathartic; it is a one way street, a note in your own timetable of mortality. It seems that whilst one parent remains you can somehow cheat yourself of responsibility; there is always someone around more senior to you holding back the waves. So how do you approach the grieving process in these circumstances?

In my opinion all the theories on the process of grieving or books of personal experiences, can never really capture or anticipate your own deeply personal reaction. Sure enough there may be something that rings true, hits home, and is a reflection of your emotions or thoughts, but that would be to miss a vital element; your relationship to that person was individual to you and only you and therefore your grief will be a unique experience. 

Finding a way to grieve can be difficult and can be dependent on a whole range of factors; the circumstances of the death, (sudden, unexplained, violent, slow) your relationship with the deceased (close, highly dependent, estranged, secret) your previous experiences of death, your economic situation, your spiritual and cultural beliefs and values and finally the attitude of society (family and wider community) around you to that death.

Being able to express your grief the way you want to has to be a positive thing. Having the right space and time (as little or as much as you need) is in my opinion a human right.  It makes me wonder for example, about a society that believes having a week off work for the death of your father, husband etc. is ok.  Sure enough you need that time to race around arranging funerals etc. but where is the acknowledgement of the time needed to grieve? The grieving process is therefore about finding your own way to miss that person, dealing with the initial shock, working through the emotions and ultimately finding a new way for you to be without that person in living form.   It can be a process of exploration not only of yourself but of your relationships with other people.  This need not be a bad thing but a moment of personal growth and life affirming.

When my father died then suddenly at the age of 84 I was completely surprised by my own reaction. The initial shock was a flood of speechless emotion. In a way I realise now that I was waiting for the call, had anticipated the practicalities of my father’s death but no one can anticipate the way you will feel. During the last few years of my father’s life he had begun to develop Dementia, but refused to acknowledge there were any difficulties. This created all sorts of practical problems as we lived more than 150 miles apart; from managing his financial affairs to dealing with the various people trying to help him who he managed to alienate to the decay of his house and his own person. This was an extremely intelligent and capable man wanting to disappear into his own cocoon and this is what he achieved with great aplomb.  It did however, along the way build up a sense of tension between us and regretfully a sense of distance. He was not the father I wanted him to be with his family and especially following the death of my stepmother, we were not able to rekindle the sense of closeness we had had when I was a child.  Whenever I went to see my father there was always a feeling of deep emotional pain, mixed up with a never expressed anger at the loss of the man I remembered.

Following the initial pain and shock of death I set my mind to the practicalities. Being an only child it fell to me to look after everything and I was glad to do it. It meant having control of creating the funeral I wanted to give my father, a celebration that showed the world who he really was not the recluse he had become. I trod the path of humanism and so was able to put together a celebration of his life, a ceremony that included no words of religion but words and music that gave a picture of his interests, achievements and beliefs. In going through this process I was able to revisit what I loved about my father and my early childhood, re connect with people who had known him and my mother(who incidentally died in my teens), find a new closeness with my family, as well as find out new aspects of my father’s character and life. This for me was the first step towards altering my relationship with my father; a revaluation of who he was by listening to other people who knew him and having the sort of honest and open conversations with family that you may rarely venture upon but in times of stress.

I decided then as my father had left no instructions, to have his body cremated. Throughout this time I was deeply conscious of some kind of internal conversation between my father and myself, I felt very close to the essence of him, as if he were telling me what he wanted to happen. I knew that he had always retained a huge fondness for the home of his birth and therefore part of my own spiritual journey had to be a trip back to that country with my father’s ashes. Practicalities intervened when I saw and felt the weight of a human body in cremated form, far too heavy to lug on a short haul flight!
It was then on a crisp autumnal morning that I found myself and my 18 year old son driving up to the Derbyshire Peak District to the family’s original home. The aim being to scatter most of my father’s remains in the river Dove in Mill Dale nr Alstonefield, a place of enchantment and memories of Cray fishing for me as a child and my family.  Fate however has a strange way of intervening. Turning a street corner in Ashbourne I bumped into my cousin and his son. One lunch and one brilliant suggestion later found us all traversing the bleak but beautiful fields over the tops to Mill Dale chatting away. My father in a rucksack on my cousin’s back, enjoying a last walk in the countryside of his maternal roots. An hours hard walking found us hooting and shouting at my waiting Aunt and Uncle below, oblivious and sipping tea from flasks in the cold.

Clear in my mind then is the moment we self- consciously gathered in a small nook below the little pack horse bridge  next to a rapidly flowing river and complete with curious walkers. Filmed by my son I can be seen shaking a large white bag repeatedly over the water, watched by my family, not in reverential silence but with a verbal curiosity regarding the flow of the contents or rather their refusal to disperse but rather to clump on mud and rocks. My father would have found this all hysterically funny, even my Aunt (my father’s sister) standing next to me peering quizzically. Then we do then what people do on these occasions; we chatted, looking at each other in the manner of members of the same tribe, drinking overly scorching tea from paper cups, hugging and saying goodbye in the setting winter sun. The long walk back to the car was brisk with the knowledge impending darkness and the need to keep warm.

This was my way of beginning to say goodbye to my father, it is my personal story and certainly as a counsellor and working with bereaved clients this has affected the way I view death.  It did in fact take me over a year to go through the series of rituals I had planned as my way of paying homage to my father and for me to memorialise his memory.

The process of grief can be a complicated and entangled thing. Sometimes we need others to help us untangle and make sense of it, to listen to our story, sometimes we just need to create our own way of saying goodbye that is meaningful to us, even if that relationship was not a happy one. What we do all need to recognise is that we are all unique and this needs to be respected. That however long it takes to adjust to the space that person’s death has created in our lives we can as human beings find new ways to live and even flourish. is a charity working nationally with bereavement and has trained counsellors.

Michelle Krethlow Shaw
Counsellor, Psychotherapist and Hypnotherapist.

Tuesday 27 October 2015

Seasonal Affective Disorder

Looking forward to a dose of SAD (Seasonal Affective Disorder)?

So how does that poem go?

'Season of mists and mellow fruitfulness, close bosom friend of the maturing sun’. (Keats)

I learned this poem for ‘o’ level English and whilst it is undoubtedly a beautiful evocation of Autumn the reality of the changing seasons for some people brings a sense of dread rather than joy.
Now is the season when the days become shorter, the nights draw in and for some people this is the beginning of their lowering of mood. The summer with all its light, a sense of energy and high levels of Vitamin D is literally fading away.  Soon you find yourself in darker mornings and evenings, dragging yourself to and from work, school run etc. Just finding the motivation seems a chore. OK so there is the prospect of the Christmas period (depending on your attitude of course) with all its busyness to keep us entertained, but then this is followed by those 3 months! Sounding familiar so far?

So what is SAD? It could be said that most of us get a case of the ‘Winter Blues’ this is the urge to perhaps sleep more, be a bit more lethargic and eat more during the onset of winter however Seasonal Affective Disorder is a bit more than this. SAD is basically a form of depression (not wanting to participate in life around you and being inward looking with low energy levels) felt during the changing seasons, mainly from September until mid-March and can be triggered at any age and by such things as a trauma, illness or life changes in this period. It is thought that in Northern Europe at least 1 in 10 people suffer from the symptoms, so if you believe you experience SAD a house move to Finland may not be the greatest idea!

So let’s look at the symptoms.  There is a list including: lacking energy and poor concentration levels, changes in sleep patterns, swings in mood, wanting to eat more, lacking enthusiasm for life around you and not wanting to take part, increases in anxiety levels, becoming more susceptible to illness, difficulties with relationships, taking up self-harming behaviours e.g. drugs and alcohol, losing interest in physical relations.

But what about the causes? Light is clearly a significant factor, some people actually need more than others or a least their eyes do. When light hits the back of the retina in the eye messages are sent to the Hypothalamus (which is the part of the brain that determines such things as sleep, your appetite, need for sex, body temperature and mood) if there is not enough light being registered for your needs then these functions slow down. In addition common to people with depression are low Serotonin levels (the feel good hormone); it is thought that the system for regulating Serotonin levels does not work so efficiently in people with SAD. Then there is the issue that depression can be triggered by illness, current or previous trauma (such as bereavement). It can be in the case of previous trauma that the body unconsciously remembers the trauma. In my own case March is always a difficult month being linked to my first bout of depression some 25 years ago. Let’s add to this the disrupted body clock (circadian rhythm). In simple terms your brain set your body clock by the hours of daylight, therefore it could be said that in people with SAD this malfunctions and so your body slows down. Finally is the question of do humans hibernate? There is the field of thought that we do to some extent.  The Pineal gland produces the hormone Melatonin which makes us sleep during the hours of darkness and switches off in periods of light.   Maybe people with SAD just want to hibernate?

So what can we do to overcome SAD?
  • ·         We all hopefully do go outdoors at some time during the day, so try to make this a habit perhaps during your lunch time.  Midday is the ideal time to exposure yourself to natural light, even if the sun is hard to find, 20 mins is great.
  • ·         In winter try to avoid becoming stressed (yes I know some chance with Christmas etc.) so try planning throughout the winter months joyful, look forward to treats, that don’t perhaps involve large quantities of food and alcohol. If you enjoy music for instance plan a program of concerts/gigs or outdoor walks, taking up Yoga or an evening class, catching up with friends. It’s all there on the Net, no reason not to plan ahead and most of us have diaries?
  • ·         Ah yes exercise, I am the first to admit I would rather read a good book in the cold winter months but really to boost those Serotonin levels indoor or outdoor sports is just great. Rigorous housework or gardening is also brilliant.
  • ·         Light Boxes are also recommended with strength of 2,500 lux. You can check this with your GP who may be able to advise on the right direction but you might also want to check the following websites:,,
  • ·         There is of course counselling; CBT is effective for mild depression and you may be offered antidepressant drugs for more severe symptoms (SSRI’s) by your GP.
  • ·         Finally ‘Bright Light Therapy’ with a health care professional.  This is not offered by the NHS but is referred to by the National Institute for Health and Care Excellence (NICE)

If you have found this article interesting or any of my other articles on this website it would be great to hear from you. Comments welcome. Just find me at michellekrethlow@gmail .com or contacts page.

Michelle Krethlow Shaw

Counsellor, Psychotherapist and Hypnotherapis

Thursday 1 October 2015

Empty Nest Syndrome

Empty Nest Syndrome is the term (non- clinical) used to describe the complex mix of emotions surrounding the departure of your last child from home. September in particular can be a heavily emotional month; not only are the heady days of summer and family time drawing to a close but for some parents it is time to say ‘bon voyage’ to those children leaving the nest and facing a new stage in their lives, one of more independence from the family unit.  This is not to say that this only happens in September of course!  

This moment in our lives can be beautifully timed; especially for women it can be a time when we are facing such factors as the menopause (challenging who we are), experiencing role reversal with our parents and the dawning reality of our own mortality. We are perhaps full of anticipation regarding the effect of being thrown together once again with our partners; cracks hitherto pasted over by the business of bringing up a family may be highlighted in sharp relief.

Until this point you have been an intrinsic part of your child’s busy life; the glue that binds, the fixer, (taxi driver, chef, laundry service provider) and host to scores of other young people bringing their energy to your house. Your role then and sense that you are your child’s nurturer, sometime confidante, and problem solver simply up sticks and walks out of the door, leaving a huge void.

The impact can be profound on your sense of self, hence the term ‘Empty Nest Syndrome’ ‘Empty Nest Syndrome can therefore manifest itself in a deep feeling of loss of identity and a grieving process that can sometimes lead to levels of low motivation in other words reactive depression.  Life is telling you it is time to change, to re- examine who you are and that can be painful.  Conversely of course you could be cheering the moment the door slams shut, breathing a sigh of relief at the last lot of washing and ringing the estate agents.

This is of course a natural step. All your child’s life your role has been set upon doing your best as a parent to develop in them a healthful independence. That is your job and you’ve achieved it no matter how you feel. This fact alone is cause to feel content.  So how can you start to cope with those low moments and turn this moment around into one of opportunity for personal growth?

My to do list

·         Congratulate yourself on a job well done. This is what is supposed to happen. (Yes I know they may return again for whatever reason at a later date).
·         You may notice peace in your household learn to enjoy. This could be an unexpected bonus, a time to be able to take up other activities without interruption for taxi rides or intervene in arguments.
·         Are you now able to give time to your career or study a subject you have just been putting off until…..well now!  Plan ahead; take time to think about those projects you would like to have done when younger and do them.
·         Remember they are still your children; this is time for you to re-evaluate what role you would like in their lives and exciting time to see them truly become adults. Keep the door of communication open, make an effort to call, text etc. just enough to give independence and make it a pleasure. ‘Tell me your news first’…..always works for me rather than a long list of woes and moans.
·          I know this is a complex area but it is worth thinking about the difference between creating a reliance on you (by perhaps always stepping in at the first sign of trouble) and an independent person who wants to communicate with you and may occasionally really need your support as a parent. Be there but don’t linger on their doorstep.
·         When your children first leave you may notice your mood swinging back and forth, this is natural and it is important to acknowledge you feel this way.  Keeping busy will help but if you think you are really having a hard time with grief, loss or depression make sure you seek support early on via friends, talking to your partner, family or counsellor. You may find the website  useful, they also have a 24 hour helpline 0808 800 2222.

Michelle Krethlow Shaw
Counsellor and Hypnotherapist
September 2015

Sunday 21 June 2015

Animals and their Role in our Lives

Every morning when I wake up I know that if I stretch out my hand across the bed it will meet my male Tabby cat curled up either by my feet or shoulders. He usually greets this probing either with one of his little vocal creeks or nuzzling into my hand with his face and then we proceed to a mutual ‘good morning’ round of him rolling onto his back and me messing up his belly fur either with my face buried there sniffing in that deep homely catness  or mussing him up with my hands.  Now this may either sound very eccentric to you, a little bit urgh or you may identify with this completely, that is your choice. However this is my way (and recognised by my family as such) of being able to motivate myself to get up in the mornings, it is my little moment of self- nurturing and totally necessary to my sense of well- being.  This short activity not only, I believe suits my cat; in that he gets his daily quota of being loved up and grooming (being a devotee of sensuality), but it gives that just waking part of my brain in the morning a positive boost through my senses of touch and smell.  It directly connects with my brain, no need for complex thoughts here, we are going straight for that burst of oxytocin, the so called ‘loved up’ hormone.

Research on the value of animal therapy is a bit thin on the ground out there, but we have all seen via Youtube and Facebook clips of the important role animals can play in giving people a sense of joy and connection with the world. Facebook and Youtube are full of animals doing ridiculous or outright cute things and we are entertained by this, but more seriously they highlight the very good work animals can do for example living in old people’s residential homes.  There are studies that show 20 minutes spent petting an animal can induce a drop in the stress hormones; cortisol and adrenaline with an increase of the self- nurturing and balancing stress busting hormones oxytocin, dopamine and endorphins. Chandler(1) asserts that there are huge benefits to interacting with animals on a physiological and emotional level, not only helping us then to interact with the world around us but in our own personal dialogue helping this to be more positive. The value in the increase of oxytocin in the words of Chandler is that as a hormone it has a strong effect not only on’ lowering our blood pressure and heart rate’ but also helps us to be more sociable.

So the next time you take time to play with your pet (or anyone else’s pet for that matter), just take a moment to reflect.  This moment is valuable in so many ways; not only because you are showing your affection for another living creature and that has to be good for you and them, but it is also an incredibly pleasant way to reduce your daily stress levels ultimately enhancing both your mental and physical health and wellbeing.

Recommended Reading
Chandler,Cynthia K. Animal Assisted Therapy in Counseling. Routledge, 2012.

Saturday 28 February 2015

Finding the right Therapist for you

Choosing the right therapist to work with can be difficult and in some cases definitely a process of trial and error.  It is perhaps important to remember that this choice is a very personal one; you are looking for someone with whom you may be sharing very difficult thoughts, feelings and emotions and so this someone needs to be someone you trust and makes you feel safe.

Most first contacts are difficult, it may be that it has taken you some time to decide to get in touch with a therapist and so in many cases you will be expecting that communication to be treated with respect. Some therapists will ask for more details perhaps over the phone or via email concerning your thoughts about how you feel at the moment and you may wish to have this brief conversation to see what kind of response you receive.  However in my experience and in these days of websites where information about that therapist may be easily available, all is needed is a brief contact to establish the time and place of the initial appointment.  

The first session is crucial and it is worth asking yourself a few questions. Quite naturally your subconscious will be working hard for you and it is worth listening to that inner voice on whether or not this feels right to you, learn to trust your instincts. Go with your gut.

Any good therapist will want to create an atmosphere whereby the client feels safe, listened to and heard in a non-judgemental way. These are some of the essential ingredients necessary for a productive therapeutic relationship, promoting the possibility for change.


  • ·        Do you feel welcome, if you feel anxious are your anxiety levels increasing or decreasing by being with that person?

  • ·        Are you given information fairly quickly to reassure you that anything that is divulged within that space and time is confidential and the background to this explained?

  • ·        What does the room feel like? Can you imagine spending time there? How close is the therapist sitting to you? Do you feel safe and comfortable?

  • ·        Does the therapist clearly say what is going to happen in this initial session? That this is a time for you to ask questions, as well the therapist working with you to establish your needs and goals in seeking therapy. The therapist will need to take an initial description from you including: your view of your life currently, maybe any past life crises as well such details such as past experiences of therapy and any medication you are taking. During this session the therapist may ask you; ‘How will you know that therapy has been successful for you?’ 

  • ·        Do you feel clear about the basis of your work together? This may include setting out an actual contract; for instance discussion about format of sessions, duration, and a broad idea about a possible treatment path (although this will change as needs change)?

  • ·        Ask yourself are the thoughts and concerns I am expressing to this person being validated? Are they acknowledging what I have to say without giving out advice (this is not the role of a therapist) or being judgmental?  Are they thoughtful and feel as if they are with me in this moment?  These are all important in deciding whether the therapeutic relationship can work for you?

  • ·        Finally don’t be afraid to say no. Just because you have gone to an initial consultation you don’t have to agree to a course of therapy with that person. The therapist will usually say something like ‘So I am wondering if this is something you would like to continue with?’ This is your chance to honestly express what you would like to do.  Even if you have had a couple of sessions don’t be afraid to say this isn’t working out for me.  Therapists expect that not all relationships work out, that is the nature of relationships. It is a much nicer way of feeding back than just endlessly cancelling appointments and then perhaps not moving on in the way you would like to.

If you have any comments about this article I would love to hear from you, especially about your experiences.

Michelle Krethlow Shaw 2015.