In this issue


Harvesting hope (free article)
Christopher Tovey considers the concept of post-traumatic growth in relation to counselling survivors of childhood sexual abuse

Taking account 
Paul Silver-Myer on the frequency with which the theme of injustice enters the therapy room

Food for thought 
Sandra Zecevic-Gonzalez on the important role of nutrition in maintaining and managing mental health


From the chair 

My practice

Business matters 

Cultural counsellor 


Relationships (free article)

Ask an expert 

Cover of Private Practice journal autumn 2017

A pdf version of this issue is available from the Private Practice archive

Welcome from the editor

For those of us who rely solely or primarily on our income from private practice to earn our living, I wonder how many will have afforded themselves the traditional practice of taking the month of August off?

It is mid-August as I write and I have returned this week to client work following a two-week break and without feeling I have taken sufficient time to fully recharge my batteries. Speaking about this to a colleague, she observed that, as private practitioners, she feels we pay twice when we go away: once for the cost of the trip itself, and once again for the loss of earnings accrued while we’re away.

In addition, we also have to manage the impact that time off can have on our clients: the phenomenon we will all be familiar with when breaks are concerned – even those that are planned and signposted well in advance – of abrupt terminations or DNAs, which can so easily generate anxiety in us about the sustainability of our practice and security of our income.

As private practitioners, we are among the estimated 1.3 million people in the UK who form what is known as the ‘gig’ economy: a labour market characterised by short-term contracts or freelance work, as opposed to permanent jobs. As Martin Hogg writes in our regular ‘Business Matters’ column, one way to manage the anxiety that comes with being in private practice, is to build a portfolio of work so that we are not solely reliant on the income generated from it.

I know from my own experience of combining private practice with other work that not only do my other different yet complementary roles provide a predictable and therefore secure base that helps contain my anxiety about the unpredictability of private practice, but my other work, because of the contrast it allows, also regenerates, re-inspires and renews my enthusiasm for client work – just as a month- long August break would, were I brave enough to take one.

This will involve my reframing a long break so that instead of considering it as a ‘luxury’, as I currently do, I instead see it as the necessity it actually is – not just for myself, but for my clients. Towards the end of a recent session in which a client had shared with me his fear that the severe trauma he has experienced in his life might be too much for me to bear – and somehow, in his mind, therefore unfair of him to burden me with – I drew his attention to his need to look after me, rather than to allow himself the experience of being looked after. I said, ‘You are paying me not just so that I can be here to look after you but, most importantly, you are paying me so that I can ensure I can look after myself.’

There is something here for me about the importance of balance, a theme that Sarah Van Gogh, another of our regular columnists, writes about. Helping her son revise for his science exams, she was struck by the phenomenon of substances and systems continuously regulating themselves to achieve balance or equilibrium, and the changes that go on as part of this process. This phenomenon is observable throughout nature and central to our work as therapists, as we support clients to navigate life’s inevitable and unavoidable upheavals and help them to internalise new and ‘healthier’ ways to self-soothe than the habitual distorted ones on which so many of us rely (like addictions, for example) – while also learning to forgive ourselves for these because, however harmful to ourselves and our relationships, they are another manifestation of the innate impulse to self-regulate.

We also see how this dynamic plays out in the collective with current global events, such as the disturbing re-emergence of the Far Right and the erosion of the centre ground as politics returns to the sort of rhetoric we have not seen since the Cold War years. In her column, Sue Lyons reflects on the way in which, so often, as a result of not being able to bear the disorder and randomness of life, and frightened by not being able to control external events, clients can unconsciously adopt a defensive position in which they blame themselves for the mess they see around them. If they can locate the problem as being inside themselves, there remains the possibility of having some control over it – it can be contained and the world does not have to be despised and hated, only the self. And, of course, as she writes, and as we see writ large on our planet today, whole societies can adopt a similar defensive structure and engage in collective acts of denial so that we do not have to face difficult realities or experience unbearable loss.

In our cover story, writing about his work with survivors of childhood abuse, Christopher Tovey focuses on the concept of ‘post- traumatic growth’, an internal self-adjustment process of ‘taking stock’ and ‘harvesting hope’, through which the stresses resulting from trauma can gradually become catalysts for achieving positive life changes. Wouldn’t it be a great thing if such a process could result from the traumas taking place in our own country and in nations across our world every day.


1. Browning C. What is the gig economy? economy/what-gig-economy/ (accessed 18 August 2017).

Disclaimer and copyright