17 May 2012

SMART Recovery - addictive behaviour support and training

I have recently been doing some online training for an organisation called SMART Recovery. I came across them by accident, when a local facilitator and representative of SMART Recovery found my blog on REBT versus CBT and called to ask about that. We got chatting and I found out what he does - facilitates meetings for people with addictive behaviour issues.

The chap in question had some good things to say about the system, so I looked into it further as I have an interest in the field of addictions. As some of you know, I did a voluntary placement with Chandos House Treatment Centre in Bristol last year (blog posts here and here).

I read up on SMART Recovery, attended a couple of meetings (they are open to interested professionals - just ask beforehand) and have just completed the online meeting facilitator training. I am fortunate enough to be able to attend Devon Drugs and Alcohol Action Team's Exploring Recovery Event day this Monday 21st May, as a professional interested in substance misuse, sharing what I have seen of how SMART Recovery works. This will be an opportunity for people from different agencies dealing with addiction to come together and share ideas. SMART stands for Self Management and Recovery Training, by the way.

I would sum up what I know of SMART Recovery thus:

1) It is a meetings based system for self-help to educate, inspire and support those committed to dealing with their addictive behaviour. This can involve any form of addictive behaviour - drugs, alcohol, gambling, compulsive shopping etc.

2) It draws heavily from Albert Ellis' Rational Emotive Behaviour Therapy which, as some of you may know, I am a huge fan of, in contrast to CBT which I think is more feeble (blog post on REBT versus CBT here). The sessions involve teaching the ABC system - A is the activating event, C is the emotional consequence. Initially clients will have a tendency to say that A causes C, For example, if I fail my exam then I will feel awful. We teach the client to see that there is a B - their beliefs about A, and this is what is causing the problem. D is to dispute the belief - the irrational outlook and E is the new, effective, rational outlook. So in this example, the belief might be, if I fail my exam it will ruin my life and I will be a failure. Well, the client might really be believing that but through Socratic questioning we can help the client to challenge their sedimented belief and see that it is their own irrational beliefs that are leading them to feel so anxious. So the anxiety will reduce. Of course, this is to be delivered in an understanding and empathic way. I have seen it work very well with the SMART Recovery meetings. Eg Somebody feels terrible because they've had a relapse. Then feeling awful about the relapse then makes them more likely to stay lapsed, because they feel so terrible about themselves. By ABC'ing them - which they do in groups at the meetings, and are given a handbook to do it at home, they can feel less bad about lapsing, and therefore not likely to relapse. The B for them might be "if I lapse then that proves I'm a failure so I might as well carry on being the failure I so obviously am". The D - disputing, would be that nowhere is it said or written that lapsing makes you a failure. The person can feel regret at their action but not shame, for they are human! It's the fundamentally humanistic quality of REBT that I like so much, but also that the client can take away a system of help which they can apply to other irrational thoughts in the future.

3) There is no affiliation with any religion, which makes it a good alternative to those that are uncomfortable with that aspect of Alcoholics Anonymous.

4) The belief behind the Smart Recovery system is that nobody is an addict; they have problems with addictive behaviour. The use of words such as "addict" and "alcoholic" are banned at meetings to ensure that there is a clear distinction between the person and their behaviour. I think that this fundamentally humanistic stance helps attendees to stop judging themselves (and others) - judging oneself leads to more bad feelings - so why do it? REBT fosters unconditional self-acceptance (USA). Unconditional other acceptance is a natural by-product of USA.

5) In contrast to Alcoholics Anonymous, people who attend meetings are invited to attend for as long as they wish to. When they feel they no longer need to attend there is no pressure to do so. The belief is that a person can choose to make changes to their addictive behaviour and can get the support when they feel that they need it. When they no longer feel they need it they can stop. People with addictive behaviours are not believed to be addicts all their lives - they can make choices. SMART Recovery believes that calling people addicts or the like promotes a sense of helplessness at their situation.

6) The system involves many tried and tested tools to help people make changes, such as the Motivational Matrix, and the Hierarchy of Values. I have tried these on friends and family, and the odd client, and they are valuable and effective.

I think that SMART Recovery will continue to go from strength to strength. The meetings I attended had a very warm and sharing atmosphere. There is really good work going on here, and sometimes attendees go on to become facilitators - using what they learned to transform their lives to help transform the lives of others. I found the attendees and facilitators inspirational and it is certainly a privilege to be able to be part of their sharing. I look forward to learning more at the Exploring Recovery Event on Monday and no doubt will have something to impart next week.

26 April 2012

A session with Yalom - Part 3

Click here for Part 1 and here for Part 2

It was damp everywhere from the recent downpour and the chair outside was wet. The home office was of modest size and elegant looking with a pretty garden.

Right on 12:30 the door opened and there stood Irv. I went inside and moved towards the fairly old and comfortable looking armchairs. The home office was a pleasing space with a relaxing feel about it, although I was far from relaxed. I was quite nervous which is probably the first thing I said to Irv.

We sat down and I registered the box of tissues on the table. Then we started. There followed just shy of an hour of interaction with one of my favourite authors and someone for whom I have great respect and admiration. I laughed and I cried.

Now, what follows is not a blow-by-blow account of all that passed between Irv and I. I did record the session with Irv’s kind permission. In retrospect I am so glad that I did as on listening back I could hear things that Irv said that I clearly did not hear at the time. A lot of what was discussed is very personal and intimate but there were some general issues that we talked about which I think that others could get some value from hearing.

How did I find Irvin? – Well, he speaks like he writes – intelligently and authoritatively, but I found him warmer than I imagined and his voice softer. He asked me a lot of questions to begin with, about my childhood, children, relationship history. I am not used to being led like this, but of course, this was a one-off session; I appreciate that he was gathering information, at quite a rate, which he later deftly wove into the session in an insightful and ultimately helpful way.

Near the start of the session I brought up the authenticity issue. Rather than an intellectual discussion of semantics and philosophy, which is what I was angling at, Irv kept it where it belonged:

Amanda: My lifelong quest is to try and find out what authenticity is, and that seems to be at the bottom of a lot of my ‘stuff’, and I have a fear that there is no such thing and that as humans we are very good at using our logic to justify our actions. I find that quite a scary concept. And I know that I, as a human being yearn for connection with others.

Irv: Can you just say a little bit to me about why authenticity is particularly important to you? How do you relate to the concept of authenticity?

Amanda: I know how easy it is to lie. Lying makes me feel uncomfortable whether it’s me doing it or someone else.

Irv: Do you have a history of that? Is it a particularly common experience…?

Amanda: I suppose I’ve been let down a lot, historically, been misled. I know that we’re surrounded by lies on a societal level.

Irv: On a societal…what about a personal level?

Amanda: On a personal level, yes, and that’s….I know there’s a yearning for connection…

From that point the topic of authenticity remained on a personal level. I think that Irvin had to steer me away from a cognitive and philosophical discussion to the personal. These issues are important to me for a reason and talking my way philosophically around them does not actually get to the root of it – me. I know this when I’m with a client and I bring them to the level of their experience rather than an external level. It was very interesting for me to listen afterwards to my subconscious attempts to take it away from me, to the safer, bigger world of outside-of-me. I hope that I am as gentle with clients as Irv was with me at steering me back to me!

He complimented me on being on this journey with 3 kids (including a teenager – one who happens to verbally challenge my stereotype-generalisation of teenagers – good for him!) and us getting on well – a journey which he knows many have undertaken, with kids, including himself, and which he understands is usually a harrowing experience.

He was very kind and helpful in pointing out the good that I have done with my life, despite certain setbacks, and pressed that I had successfully broken the cycle (he had to press as I just wasn’t taking it on board, and, indeed, it was only on hearing the recording that I finally heard it properly!). So I got a lot out of that.

Irv asked about my counselling work and I took the opportunity to ask about one of my themes:

Amanda: Is it an authentic healing process or do we subconsciously pass on our construct resulting in the client taking on a similar construct?

Irv: That’s a good question. They’re taking on what you give them and they have to see it in the light of their own internal language. They build it again inside of them to fit with their own past experiences. I’ve never had the feeling that people take on my construct. But they build a new one because their whole life circumstances are so very different. And for you, you will get certain things from seeing me or seeing your therapist… and other people won’t do it that way, they’ll take other things. Everyone deals with it quite differently. So I think, my only feeling is you really just have to be present with your clients and give them what you can, and trust them to take what they need out of it.

This was great for me to hear as for me it is being present with the client that seems to work best. I shared with Irv that I think that therapy is about the relationship I form with a client, and they see that I actually feel love for them, that they perceive that somehow.

Irv: They have a capacity then to form a really good relationship once in their life at least or be with someone who can actually love them. Well, that gives them an internal reference point, they know they’ll be able to do that again, and will keep you in mind a lot. I think that’s really important.

The session then turned again to more personal issues – of course those issues are part of who I am and I was grateful to explore in the greater context of the situation – meeting my hero and receiving his wisdom.

We talked about my disappointment at his cancellation and my discomfort around being less important to him than he was to me. Referring to what he had gleaned about my childhood experiences, he seemed to really empathise about why this might be particularly difficult for me. I really felt that he had a lot of understanding of what it must be to be me.

I asked Irvin what he got out of what he does:

Irv: A great deal. First of all, the same things you’re saying. It’s important for me and it gives me a sense of meaning in my life, to be able to work with people and give them some meaning as well. The other thing is, and I think this may be true for you as well, is that I feel that I’m pretty good at this, I know what I’m doing. And I think you do have a bit of that also, and you know, it feels good when you do something you’re being really effective in, so there’s that. There’s something about the whole intimate connection , even though it’s very brief, it is always warming to me. There’s something about, I like to get into the lives of other people, to their stories. Maybe as a writer there’s some of that for me too...its not their story but it’s an idea…ignites in my heart.

Amanda: That’s interesting that you say that because you get ideas for the stories you write and you like getting into other people’s lives and stories and I do feel a little bit guilty about that…hearing other people’s secrets…I feel so privileged but also, a bit…not scared, but in awe of the fact that I’m in that privileged position and that they trust me that much.

Irvin then referred to a paragraph he wrote in his book “The Gift of Therapy”, which I have reproduced here as it is a poignant and important point for therapists:

“We are cradlers of secrets. Every day patients grace us with their secrets, often never before shared. Receiving such secrets is a privilege to the very few. The secrets provide a backstage view of the human condition without social frills, role playing, bravado or stage posturing…Those who are cradlers of secrets are granted a clarifying lens through which to view the world – a view with less distortion, denial, and illusion, a view of the way things really are.”

With that in mind, I can see why, with my lifelong quest for authenticity, I find my work so rewarding. And if I can help anybody feel as content and passionate about life as I do, then it is with purpose.

On reflection, something else incredibly valuable I have gained from this session, is that my thoughts around therapist self-disclosure have been solidified. There are many, wildly differing opinions about the appropriateness and usefulness of therapist self-disclosure. One of the things that attracts me to Yalom is the honesty he reveals in his writing and in session with him I felt I knew enough about him to feel comfortable with him. His honesty about his shortcomings and humanness put me at ease before I even met him.

I have, since starting private practice, decided to be as upfront as I can about myself and my approach in my marketing literature. Anyone familiar with my blogs will see that I reveal a lot more in my posts than many other counsellors do. The reason why I do this is that I want people to have a flavour of who I am and what they can expect – what makes me different to other counsellors, rather than what makes me the same. The aim is to give the client real choice – to enter into a therapeutic relationship with me with open eyes. Now, post-Irv, I have real experience of the benefits of knowing something about the therapist beforehand.

My thoughts throughout have included the relationship I have with my own therapist. Indeed, it was he who recommended Yalom's books to me when I was first training. From my point of view I have a safe, trusting and wonderful relationship with him. After the session, I couldn't help but compare him to Yalom, and would say he is at least as good. In fact, I would always choose my therapist when I reflect on what we have shared, how I have grown through my relationship with him, and because he is who he is.

The session with Yalom taught me a lot about myself, and my work. The personal development began long before the appointment itself and continues, as the session becomes a memory, and I ponder on what we discussed, and integrate it into the present.

Most important, of course, is that Irvin Yalom is still one of my heroes.

A final point - I strongly urge anybody involved in or interested in the counselling and psychotherapy profession to read Yalom’s non-fiction works, and for everybody to read his fictional works.

With thanks to Irvin Yalom for his kind permission to include quotes from the session and the excerpt from his book.

25 April 2012

A session with Yalom - Part 2

A Session with Yalom Part 2

We covered a lot of miles on our journey – over 3000. I had a lot of thinking time, and sure enough, as we drove through mountains, past huge lakes, through deserts, some thoughts did start to formulate. I wrote down notes in the car (which I can barely read). Some of the themes of fears and insecurities for me that were brewing were:

Authenticity – what is it really? Is everything an illusion? Is our logic and our rationality a tool with which we justify our actions?

Connection – what is the source of our yearning for connection? Conception in the product of union; being born is the ultimate divide. Is love a construct to attempt to gain the approximation of the togetherness of gestation? And is death, therefore, sweet relief from the inevitable lifelong pain and yearning?

The process of counselling/psychotherapy – is it an authentic, healing process or is it a construct to make the therapist feel better? Do we subconsciously pass on our construct resulting in the client taking on a similar construct leading to them feeling better because we have passed on our way of coping with existence? Do we help clients replace “unhealthy” and dysfunctional constructs with more workable and life-enhancing constructs?

Freedom and choice – It feels to me like we have a choice and I operate from that level. But I also feel that there’s something bigger than me (fate, destiny, chance…) that has resulted in my capabilities of choice. I struggle with understanding how others do not see it the same way.

Childhood “stuff” – just thinking about bringing some old, personal issues into the session had me feeling nauseous. Such a strong reaction showed me that I should perhaps not avoid this topic. After all that cognitive stuff above, this was a gut reaction to old pain. Do I really want to revisit when it’s all behind me? Well, who better to entrust it with?

All along the lead up to the session, I had a background fear that Irv would get sick and cancel. I did not dwell on it – I did not want to send negative vibes out into the stratosphere (how grounded does that sound?!), so I allowed myself some excitement of the anticipation, but it was safely contained, should the worst happen. Coincidentally(?) my daughter brought up one of her deep thoughts for all to share, during our journey, such is the gift that she is, which I wrote down in my notes:

“It is better to not be too happy because if you are, and things go wrong, it feels worse than if you were just a bit happy”.

We talked about this for a while and I told her that I think that sad and bad things are part of life, and that curtailing happiness won’t stop them from happening, and that embracing the happiness makes the most of it while we have it, making the bad things easier to tolerate when they happen. Whether I manage to do that myself is something I am unsure of. I am closer to it, and in this instance I did allow myself some excitement, but yes, it was “safe” excitement.

So, on the morning of the appointment, in a hotel in Sunnyvale, close to Palo Alto where the appointment was to be, I woke up excited and ready. After breakfast, I decided to check my emails and there it was, a profuse apology from Irvin that he had woken in the night feeling terribly sick. I felt crushed, and quite numb. All that build up, all that supposedly safely contained excitement and I was gutted. He mentioned that if he made a miraculous recovery maybe I could see him the next day, but what’s the chances of that? My colds/flu are always worse on the second day.

I knew it. It wasn’t going to happen. My husband and kids were so disappointed for me – they were more visible about it than I was. I numbly got on with the day as we changed our plans and went to Monterey, in the pouring rain, early. The Facebook responses to my disappointment were helpful – so thank you to my friends and family for your empathy.

Because there was a small chance of a miraculous recovery, I did not allow my disappointment to flow freely. I protected myself from the depth of emotion and saved it for when I knew it was definitely over. We had a bit of a downer of a day – it rained continually the entire day, the forecast was for pure rain within a 5hr radius of Monterey (indeed, the whole of California) for the rest of our time in the States, and the visit to Monterey Aquarium was disappointing. We have been spoiled with Plymouth Aquarium, and I had visited Sydney Aquarium 17 years ago, with which Monterey is supposedly on par. Well, it just wasn’t that great, after the huge build up and misleading brochure. Also, the kids were beginning to feel really homesick

That night I decided to do some believing in the reality I wanted (I have been reading Joe Dispenza’s Break the Habit Of Being Yourself which goes on about Quantum Fields and creating new realities). So I pictured waking up to a sunny sky and a message from Irv. I imagined the experience of this being so and fell asleep…

So I awoke to sunshine, but no message from Irv. I decided to email him and find out if it was a possibility, so I could get on with the process of expressing my huge disappointment (which was still on hold), then get on with the rest of the trip. The act of writing the email brought up a lot of feelings for me. I realised how much this meant to me and I had uncomfortable feelings around that. I felt anger towards Irv for being ill, and for the fact that this was way more important to me than it was to him:

“Hi Irv, I am sorry to bother you, particularly if you are still feeling very ill. We are making our plans for the day and I was just checking in the faint hope whether there was any chance for a reschedule today… If there is any chance I would be most grateful, and yet I feel uncomfortable being in the situation where I am this desperately hopeful and dependant upon circumstances and somebody else. This is very complex. Regardless of the outcome I guess I have stuff to take away to process. Anyway, an update would be good.”

Why was this so difficult for me to write?

Well, anyway, I'm glad I did as I got an email from Irv telling me he was feeling better and would 12:30 be okay. Unbelievable. By now we were about an hour and a half away. My husband and kids were really pleased for me, even though it involved disrupting their day. So off we went.

At 12:25 I arrived at Irvin’s home office and waited a few minutes outside, feeling very excited, very nervous and ready to go.

Click here for Part 3

17 April 2012

A session with Yalom - Part 1

I think that everybody that knows me is aware of the fact that I met somebody I greatly admire last week, and how much it meant to me. I knew before I did it that I would want to blog about the experience. Maybe it's the jetlag (I've been back for 3 days, and was 8 hours behind GMT), but I have been flummoxed as to what to write. So, I have kicked off with a precursor. I fear my self-indulgent blathering might greatly bore anybody but the most ardent Yalom fan, and if you wish to go straight to the session itself, click the link to Part 3. Here goes...

Why do it?

While planning our recent trip to the States, it occurred to me that the world famous psychotherapist and author Irvin Yalom practices in San Francisco. I have read most of his books and he has had a great influence on the way I practice. He is a source of inspiration and I regard him as one of my (few, select) heroes.

He writes fiction as well as non-fiction. His non-fiction works are far from stale, dry textbooks. He breathes life into them by using himself, as much as his anonymous case studies, as examples. In particular, I appreciate his honesty and transparency about his own flaws. He is intelligent, creative, wise, human and lacking in arrogance.

Irvin Yalom switched me on to my own existential slant on life. I am aware that as a very young child I spent hours (at least if felt like hours) thinking about what it is like to be another, how we are unable to get into other people's heads, that we all have our own version of reality based upon how we perceive. I brooded on life, death, purpose, loneliness - which Yalom cites as common human concerns. As I grew out of childhood I learned that this was all way more complex than I was capable of understanding - in fact, I see getting older as a positive thing in that I can get closer to understanding what reality is, or at least, what reality isn't.

When I trained in my Diploma in Integrative Counselling, my favourite module was that on existential therapy. Indeed, I would definitely say that existential therapy is a substantial part of my approach. The main part of my approach, however, is my emphasis on the quality of the relationship between the client and myself. Yalom describes himself as working from "an interpersonal and existential frame of reference" which is close to where I am, approach wise. I describe myself as person-centred with an emphasis on relational depth, underpinned with an existential frame of reference. The person-centred approach, much as it is debased with fluffy overtones by those that do not understand how challenging it can be, if embraced fully, closely matches my way of being in a therapeutic relationship.

So, back to Yalom. Much of what he writes speaks to me in my language - it inspires me and I feel sets therapists free in that he shows how our imperfections, and how we deal with them, are valuable to our clients. It's okay not to be perfect - it's what we do with mistakes that can actually enhance learning. Yalom writes in such a convincing way, with such authority. A true wiseman.

His works of fiction are outstanding. I abhor most fiction and find it lifeless and dull. It is very hard to convince me to believe in and care for a character. There is almost always something implausible about how they speak, dress, or, usually, relate to others. This is where Yalom triumphs. His characters are deep, complex and utterly convincing. The first novel I read, When Nietzsche Wept, had me gripped throughout. He deftly weaves a fictional tale based on two real characters - the philosopher Nietzsche and, the layer of the foundations of psychotherapy, Josef Breuer. These characters did not meet in real life but what is written is a fictional account of the development of a therapeutic relationship between these two influential and pivotal men. It is utterly convincing and I was sobbing like a good 'un by the end of the book.

He has also written a novel "Lying on the Couch" - described by my friend Robin as "the best counselling book ever" (with which I wholeheartedly agree). It is a book which traverses the truly complex nature of therapy with themes such as sex, gambling, corruption and morality. There are no black and white messages, in fact, there is no message. It is a reflection on how life is - full of grey areas and agonising decisions on whether we need to justify our behaviour and responses. No easy answers here - and that's what I love about it. There is also "The Schopenhauer Cure" - a fictional account of a therapy group. The same applies - grey areas, no goodies and baddies. Just 3-dimensional people - flaws and all. A great, convincing ending too (possibly not to everybody's taste though). I am eager to read his new novel "The Spinoza Problem".

So, when it occurred to me that I could in theory meet the man, and perhaps engage in a therapeutic session with possibly the world's most famous (living) psychotherapist - I decided that I had to at least enquire.

The request

I attempted to capture Yalom's attention by writing in my individual and honest style. I was upfront about why I wanted to meet . Here are a couple of excerpts from that email. I have not included it in it's entirety as some is very private. I sent this last July:

"I am attracted to the honesty you reveal in your writing. From what I can glean from The Gift of Therapy - you are able to authentically express yourself in the therapeutic relationship. I enjoy the way you dare to tread in the grey areas - crossing the boundaries that therapists can cling onto due to their own fears. I see myself as being intrepid and would rather face the discomfort of honesty than the safety of the cocoon of collusion....

So, I hit 40 next year. It's just a number, and it hasn't got anything to do with anything...except, it's a great excuse to do something I REALLY want to do. By chance, partially thanks to my recently revisited (yet again) Death Anxiety, the grave reminder that life is too short, I am coming to America next Spring with my family. We are going to blow a modest inheritance on seeing things we really want to see - Yellowstone, Grand Canyon, Lake Tahoe, Death Valley, Redwood forests etc etc and part of the trip will be driving up to San Francisco...

We will be travelling in the area around the second week of April next year. Is there any chance of us arranging anything? I have fears around this...what if you don't read this or get back to me? What if you do, and we arrange something, and I get all excited, then you have to cancel? What if something happens on our trip and I don't make it? What if we meet and it is a disappointing and empty experience? This is me putting myself out of my comfort zone."

I feared that I would not hear anything back at all, or that I would have to wait a long time. However, I received an email the following day, saying that it was certainly a possibility and that I should contact him nearer the time.

I was thrilled! Part of me was certain that fate would interfere and it would not happen, but I was delighted to have received a response from "Irv".

I did contact him at a later date and secured an appointment which would fit in with our travel plans - well, we worked our travel plans around what was available. Fortunately, my very understanding partner rates Yalom very highly as an author and knew how important it was to me

Many people balked at the amount I was willing to pay, however, some did, on reflection, say that they would probably be willing to do likewise, considering who it was. Regardless, it was worth it to me - for personal and professional development.

Then all there was to do was to wait. In the meantime I was frequently asked "what are you going to talk to him about?". But I made the conscious decision to wait and see what came up for me. Shortly prior to the trip, I was devoid of any issues I specifically wanted to take to Irv, but that changed once the trip commenced.

Click here for part 2

Amanda Williamson Counselling Service in Exeter, Devon. BACP Registered and Accredited Counsellor.

12 March 2012

Current reading matter...

I always seem to have a few books on the go. They are mostly books on psychotherapy/counselling/philosophy and looking at the pile beside the bed, my current selection is in keeping with my norm.

The current favourite (that is, the one I am most excited about) is Joe Dispenza's latest offering "Breaking the Habit of Being Yourself - How to Lose Your Mind and Create a New One". I find the title slightly harsh, but I appreciate his sentiment. I very much enjoyed his previous book "Evolve Your Brain" and did a presentation pretty much based on his work. He draws from neuroscience, biochemistry and quantum physics to describe how our minds work and the influence we can have on making our minds work for us, rather than falling back on ancient, hardwired "survival"strategies to get by in life. Fascinating stuff. This book seems to be a more user friendly version of the first book and has much more about meditation and mindfulness as a way of braintraining, describing the neuroscience behind why what he is saying actually works. I have only just started it and will blog a review on it when I am done.

There is also a copy of The Way of Zen by the British philosopher Alan Watts - given to me by my friend Robin who is a huge fan of Watts. It is a marvellous book, in that, so far, it seems to be able to communicate some of the trickier concepts of Zen Buddhism and Eastern thought, or at least, I think it does. It is tricky to read as it challenges the Western perceptions which are part of my psyche via nature and nurture. I need peace and quiet and a lot of focus to finish this one.

I adore the neorologist Oliver Sacks' writing and have had "A Leg to Stand On" by my bed, on and off, for years now. The book, which is about the author's recovery from a nasty accident involving his leg, is not as fascinating to me as his other stories. One of my favourite books of all time is his "The Man Who Mistook his Wife for a Hat". I will get around to finishing A Leg to Stand on one of these days....

There's always a text book in there. The current text - and the book which I am getting through at a greater rate than the others, is "Skills in Existential Counselling and Psychotherapy" by Emmy Van Deurzen and Martin Adams. This was recommended to me by my therapist, who has a similar approach to me in counselling, i.e. person-centred with existential traits. It is a very straightforward description of what it means to practice therapy with an existential approach. It makes perfect sense to me, but maybe that's because it speaks to me in my language. I highly recommend it for trainee counsellors, particularly if the training involves a module on existential therapy.

Lined up for me, ready to read after finishing Skills in Existential Counselling, is Yalom's weighty tome "Existential Therapy" which, apparently, is a great read for anybody interested in human existence. I am looking forward to reading this and Yalom is without doubt one of my favourite authors. He writes both fiction and non-fiction exquisitely.

Finally, a little bit of fiction. I have a book of short stories which I have had for some time, but took a break from. I am ready to dip back into it (it is a huge book of short stories). It is called "Songs of the Dying Earth" and is a collection of stories written by various authors in honour of sci-fi author Jack Vance. His specialised genre was called "Dying Earth" which is about the future of humanity, when the sun is dying. Very existential. I also managed to acquire a copy with the beautiful illustrated jacket.

I have always been fascinated with the concept of the end of the world since reading, when I was about 10, that the sun was going to expand and fry the Earth in 100 billion years, then retreat and leave the Earth cold, lifeless and desolate (I think that science has changed it's mind slightly on this one). The sci-fi sub-genre of Dying Earth was introduced by H G Wells in his novel "The Time Machine" where the time traveller goes forward in time to find the earth virtually inhabitable. This was left out of the original print as it was deemed too scary for the general public. I must admit that I find the concept extremely haunting and it stirs a little anxiety in me. It also makes me appreciate what I've got what right now, while I've got it.

Amanda Williamson Coaching and Counselling Service in Exeter, Devon

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