Philippe Jacquet

They arrive because the drinking has become a problem. Or because they train every day and their partner has finally said something. Or because a relationship is failing and they cannot work out why. Food is not on the list. It has often never been on the list.

This is the difficulty with eating disorders in men. They tend to be hidden inside something that looks like a different problem or inside something that looks like no problem at all.

A man who drinks every evening will eventually be asked about it. A man who trains every evening gets congratulated.

That is the trap. Discipline and willpower are admired, and rightly so. But for some men the gym is not discipline. It is a prison. It is not something they choose each day; it is something they cannot get out of. The commitment other people praise is the thing holding them in.

There is a simple test, and you can run it on yourself this week. Do not go once. Stay at home and sit with how you feel.

If that is harder than going, that tells you something. And if it is genuinely unthinkable, that tells you more. For some men, missing a single session would be the greater act of willpower by far.

The gym is only one of the shapes this takes, and it happens to be the one that gets applauded. There are others.

There is the man who has been dieting for twenty years and is still the largest person in every room he walks into. He knows more about nutrition than most clinicians. He has started again on a Monday more times than he can count. Nobody around him thinks of this as an eating disorder; they think of him as someone who ought to try harder. So does he.

And there is the man who gets the joke in first. He comments on his stomach before anyone else can. He is the one who makes himself the punchline in the changing room, and he is good company about it. That is not confidence. It is a man taking charge of the one humiliation he knows is coming, because owning it hurts less than receiving it.

Those three look nothing alike. One is admired, one is judged, one is good value at a party. The struggle underneath is identical. Food, weight and shape are being used to avoid feeling something, and an entire complicated life is being narrowed down to a single measurement.

That narrowing is not a side effect. It is the function. It is far simpler to be at war with your body than to sit with the questions a life keeps putting in front of you, about work, intimacy, meaning, getting older. A number is a problem with a clear answer. The rest is not.

This is a composite, drawn from many years of this work rather than from any one person.

Picture a man of forty-three. He is not in any visible difficulty. He has a job people respect and a marriage that is quiet rather than unhappy, and he is in better shape than most men his age. His colleagues make admiring remarks about the discipline.

He comes to see me because his wife said something. Not about food, about the gym. He goes six days a week, sometimes seven, and he has started arranging holidays around whether there is one. He describes this with a kind of embarrassed pride, because he knows how it sounds, and he also believes it is a virtue.

Food comes up in the fourth session, not the first. He eats the same seven things. He weighs them. If he eats outside that, the next day is longer in the gym to correct it, and he does not experience this as punishment; he experiences it as arithmetic. He has never once used the word 'diet', and he would reject the word 'disorder' outright.

What he will eventually say, if the room holds steady long enough, is that he has not wanted sex in about two years and has concluded there is something wrong with him as a man. He has not told his GP, because the conversation would have to begin somewhere he cannot begin it. He has not told his wife either, so she has drawn her own conclusion, and that is the real reason the marriage is quiet.

Everything in that picture is treatable. Most of it reverses. But none of it gets looked at, because every visible part of it is behaviour the world applauds.

Go back to that extra session, the one correcting yesterday. He experiences it as arithmetic. It has a clinical name, and it is one he would never apply to himself.

Most people believe bulimia means eating and then vomiting. It does not. The criteria require bingeing and then compensating to prevent weight gain, and the compensatory behaviours have always included excessive exercise, alongside vomiting, laxatives and fasting. Purging calories through the gym is purging. The structure is identical: take in a large amount, then undo it.

This is one of the main reasons men go unrecognised, and one of the main reasons they never refer themselves. A man who has never made himself sick is quite certain he does not have bulimia, and so is everyone around him. What he has, as far as anyone can see, is a training regime. What he actually has is a binge and a compensation, and because the compensation happens in a gym rather than a bathroom, it gets admired rather than noticed.

So I would ask anyone working with men to hold the question open a little longer. Not "Is he making himself sick?" but "What happens the day after he eats more than he meant to?"

Men feel ashamed of their bodies, and through their bodies, ashamed of their masculinity itself. What cannot be said out loud is not "I'm worried about how I look." It is closer to: I don't feel like a man, and my body keeps proving it.

That takes a different shape depending on whether a man is on his own or with someone, though it comes from the same place.

For a man on his own, it is visible in what does not happen. He does not approach the person he is attracted to, or he approaches expecting to be turned down and is. He needs a drink before he can be seen naked.

Inside a marriage it is quieter and much harder to see. Desire goes quiet, or his body does not respond, and he takes that as the final verdict on himself. Rather than say any of this, he withdraws. His wife, having nothing else to go on, concludes that he has either stopped wanting her or is seeing someone else. Neither is true. He will not correct her, because correcting her would mean explaining, and the explanation is the very thing he cannot say. That is how a marriage becomes quiet without anybody deciding anything.

Speaking would also mean stepping out of whichever role is keeping him safe, and every one of these men has one. That is why nothing gets said for years.

When a man trains hard and eats too little for what he is doing, his body lowers testosterone to conserve energy. Low desire and difficulty with erections follow from that directly. Sports medicine calls this relative energy deficiency, and it is a fuel problem, not a character problem.

So the discipline he is using to feel more like a man is quietly taking his masculinity from him. The part I most want men to hear: it reverses. Eat more, train less, and the body comes back.

I want to be clear first, because this argument gets heard as a position it is not. These medications are a genuinely good thing. For someone with a cardiac problem, with diabetes, with a real medical indication, they do something valuable and I have no argument with them.

But using them to treat an eating disorder is like treating the hair loss and calling it cancer treatment. It addresses the visible part. It does not address the underlying issue.

For a man with an eating disorder, weight and shape are not really about weight and shape. They have become a way of regulating himself, of finding safety, and above all a shield: against the world, and against his own feelings. While he is occupied with his body, he is not in contact with anything else. This is not a side effect of the preoccupation; it is its purpose.

This is also why the medication so often disappoints this particular group. Drugs like Ozempic and Mounjaro suppress hunger and produce fullness. But a man with an eating disorder eats for reasons other than hunger and continues eating even when full. He eats to avoid how he feels. Remove hunger, and the reason remains, so the result is often not relief but despair.

What I see instead is that the behaviour moves. One man I worked with began a prescription and, within weeks, started vaping. More commonly it goes to compulsive masturbation. The regulating has to happen somewhere, and if food is chemically closed off it simply finds another door.

None of this is an argument against prescribing. It is an argument for one question before the prescription: not what the man weighs, but what the eating is doing for him. A man who cannot answer that is unlikely to be helped by having his appetite removed.

There is one more turn to this journey, and it is the part that costs the most.

Almost every man I see in this position is living in preparation. Not now, but when. When the weight is down. When the body is right. Then he will go out properly, or date, or take his shirt off on a beach, or apply for the thing he wants, or be easier to live with. The present is a waiting room. Real life is understood to begin on the far side of an imaginary body.

That body never arrives, because it was never really a weight. It is a condition of being acceptable, and it moves exactly as fast as he does. Men who reach their target number often discover, within a few weeks, that the number has quietly changed.

So the years spent waiting are simply wasted. That is the true cost, more than the training or the food: a decade of ordinary life postponed against a condition that cannot be met. Whatever meaning might have been built in that decade was never permitted to begin, because meaning was not allowed to count until the body was right.

It is also why I am wary of any intervention aimed straight at the weight. It can look a great deal like progress while leaving the waiting room completely intact.

I wish I could tell you which treatment works. Nobody can say in advance whether therapy, or this particular therapy, or something else will be the thing that helps you.

What I know is that it comes down to trying. Something that doesn't work is still useful. It's information. Only the people who stop trying fail. There is no single thing that works for everyone, and finding yours takes more than one attempt.

Start by saying it out loud to one person. That is usually the hardest part, and it counts as treatment.

The Eating Disorder Nobody Thinks to Look For

Nancy Dewe Mathews

What role can art play in a mental health hospital? For Hospital Rooms, an arts and mental health charity celebrating its tenth anniversary, the answer lies not only in the artworks people encounter, but in the opportunities they have to make art themselves. 

Working with artists, people with lived experience and NHS staff, Hospital Rooms transforms mental health environments through ambitious contemporary art and creative programmes. At the heart of this work is a belief that people receiving mental health care should have access to 

, quality materials and experiences that pinvite imagination and participation. 

Feedback from NHS staff involved in Digital Art School, our free programme of artist-led video workshops and art materials, offers a glimpse of what this can mean in practice. 

Creative activities in hospitals need to work within the realities of ward life. Staff have different levels of artistic experience, patients have varied interests and abilities, and opportunities to bring people together can be limited. Digital Art School offers a flexible way to make art accessible, with recorded and live workshops that staff can use with groups or individuals. 

Oliver Soriano, Chief Nursing Officer at Lancashire & South Cumbria NHS Foundation Trust, describes how the resources have supported staff across 13 sites and 27 wards. 

“We all know that art is not everyone's forte, but the videos that you produce have enabled staff that would not describe themselves as artistic to confidently lead sessions.” 

For Oliver, the videos also give patients a chance to see what an activity involves before deciding whether they want to take part. He explains that this approach has helped staff engage people who may not previously have been drawn to art. 

Access to materials matters, too. Oliver notes that the quality of supplies available through the project can make a difference to what people are able to create, giving service users the chance to produce work they feel proud of. 

The combination of guidance and materials means that staff do not need to be artists themselves to help make creative activity possible.

A shared focus and a sense of achievement 

The value of these sessions is also reflected in the everyday experiences staff describe on their wards. 

Alison Ingham, Recovery Worker at Rose Ward, Gosport War Memorial Hospital, has seen how workshops can bring patients and staff together around a shared activity. As she puts it: 

“The workshops used were really helpful to engage patients to be creative. We have enjoyed all the workshops and all the patients and staff worked together to be creative and forget about current worries and focus on something positive.

Alison describes how work created during sessions is displayed in the ward corridor. Seeing their pieces on display can give patients a sense of pride in what they have achieved, while offering others an invitation to participate. 

For some people, the structure of a workshop provides a helpful starting point: a set of materials, an artist’s guidance and a process to follow. For others, the opportunity to work quietly and at their own pace may be more appealing. Recorded workshops allow staff to revisit activities and fit them around the needs and rhythms of their setting. 

Yvonne Ellis, Occupational Therapist at Woodleigh Community in Croydon, has used Digital Art School since its early days. She describes how patients respond to the sessions: 

“They all find the group calming and relaxing and always look forward to the next class.” 

She is equally clear about the importance of the resources that make participation possible: 

“Without your free art materials we would not be able to participate.” 

For this year's Digital Art School series, Hospital Rooms is collaborating with the charity ActionSpace to bring workshops from 4 incredible artists over the coming months, including: Mohammed Imran Khan, Declan Leslie, Sharon Adokorach and Immanuel Adelowo.  

Bringing contemporary art into hospitals 

Alongside opportunities to make art, Hospital Rooms works to bring contemporary artworks into NHS mental health environments. Our tenth-anniversary initiative, 10 Posters for 10 Years, is distributing 10,000 artworks to around 1,000 NHS mental health hospitals and settings across England, including acute, secure and locked wards. 

The series features ten leading contemporary artists, including Jeremy Deller, Antony Gormley, Celia Paul, Grayson Perry and Anish Kapoor. By placing artworks in hospital settings, the initiative extends access to contemporary visual culture beyond galleries and into the environments where people receive care. 

The posters sit alongside Hospital Rooms’ wider work to transform clinical spaces through art. They also reflect the idea that access to art should not depend on where someone happens to be or the circumstances they are experiencing. 

The final poster in the anniversary series is Glow by Anish Kapoor, a longstanding supporter of Hospital Rooms. His relationship with Hospital Rooms includes Breathing Blue, an installation created for the Snowsfields adolescent mental health unit at Maudsley Hospital. 

Reflecting on the role of art in these environments, Kapoor says: 

“Art in a clinical environment helps to create an opening, a moment where the wall dissolves and the mind can travel somewhere else.” 

Whether someone is encountering an artwork on a ward wall or taking part in a creative workshop, art can offer a point of connection and an opportunity for expression. 

As Hospital Rooms looks to the next decade, the ambition remains to make these experiences more accessible across mental health settings - not as an addition reserved for a few, but as a meaningful part of the environments in which people live and receive care.

Written by Nancy Dewe Mathews, Communications and PR Consultant, with case studies gathered by Freya O’Brien, Digital Art School Lead and Haley Moyse Fenning, Head of Impact.

How Art and Creativity Can Inspire Patients in Mental Health Hospitals 

Harriet Griffey is an ex-nurse, journalist and published writer. She also facilitates writers retreats and her latest book Write Every Day is out now from Hardie Grant publishers.

Photo credit: Julia Burstein

Harriet Griffey

It was an interesting commission, to take the 1922 children’s classic 

 by Margery Williams and explore its enduring lessons for life, relevant not only for the children for whom the story was first written, but also for those grown-up children we become.

, the original text with an exploration of the key ideas expressed through its gentle storytelling — how we become real and move towards authenticity, the value of resilience, the enduring power of love, the wisdom that can come with age, the joy and fun of friendship, the acceptance of loss.

Williams knew about loss. Born in London in 1881, she was seven when her father suddenly died. Then, in her 40s and a mother herself, living in the US she wrote 

. It was originally commissioned by Harper’s Bazaar magazine in 1921, to accompany illustrations by her child prodigy of an artist daughter Pamela Bianco, and billed as a ‘fairy story for grown-ups’, its universal themes resonating with a generation that had lost so much from the 1918 flu epidemic and WW1.

The following year the story appeared in book form, with illustrations by the well-known British artist William Nicholson, and became an instant classic. The book has been in print in various incarnations ever since, beloved by generations and showing up in popular culture from time to time — the 1988 film 

 — it was Chandler’s favourite children’s book.

There’s a reason why children still find its story holds good. At its heart the story addresses the idea of what it means to be real but it’s also about negotiating the early lessons of life. The velveteen rabbit is a Christmas gift to a small boy, who loves and cherishes him. Some of the other modern, clockwork toys are condescending and snub him, which he finds hurtful, while insisting 

is not. In the nursery he is befriended by the wise Skin Horse, to whom he asks, ‘What is Real?’ and is told that becoming real takes time and by the time it happens, ‘...most of your hair has become loved off [...] you get loose in the joints and very shabby. But these things don’t matter at all because once you are Real you can’t be ugly, except to people that don’t understand.’

As professor of psychology Bruno Bettelheim wrote in his 1976 book, 

The Uses of Enchantment: The Meaning and Importance of Fairy Tales

, ‘The child intuitively comprehends that although these stories are 

 …’ and as children, through fantasy and imagination, we learn truths about our feelings and experience and here, through the telling of this story, what it means to become real begins to take shape.

And through this story the value of resilience and kindness, the importance of authenticity, and that true acceptance comes from self-acceptance, becomes gently apparent. In 

 terms, it’s the process of individuation that occurs as we mature towards adulthood, the integration of the conscious and unconscious parts of our psyche, discovering and accepting ourselves in a process of becoming ‘real’, just like the velveteen rabbit, attaining the authenticity that enables us to live well-balanced lives.

‘The mission of fantasy, far from belying truth, is often to present truth in an understandable form,’ wrote Williams in 1929, and her insights about this process lie at the heart of the story of 

. Working on this, pondering on its life lessons during a time of geopolitical turmoil and socioeconomic stress for so many, it was curiously life-enhancing to pause and reconsider some of the universal truths about love and resilience and magic enshrined in a century old children’s story.

 by Harriet Griffey, illustrated by Emma Carlisle, is published by Rizzoli, price £14.95

Learning About Life from Velveteen Rabbit

Annette Byford

Louise Chunn is a prize-winning journalist and former editor of a number of magazines, including Psychologies, Good Housekeeping and InStyle. She is the founder of Welldoing Ltd.

Louise Chunn

Annette Byford is a longstanding Welldoing therapist and author of two non-fiction books relating to family relationships. For these she spoke to a range of individuals about their family dynamics, and the ties and fractures that can occur over the years. But nothing in either 

Byford is originally from Germany but has lived in Southern England for decades. In recent years her mother has died, and she has written 

about how she had started first to write about her mother’s life, not thinking that anyone other than close relatives might be interested. But, inspired by the times in which her mother had lived, and her mother’s romantic entanglements, she found she was writing a book, which was published first in Germany, and now in the UK.

At the centre of the novel, which she describes as auto fiction, is Byford’s imagining of her young mother’s quotidian life and fantasies in the years following the Second World War. As she writes “No German person can be at ease with themselves at this time.” Bomb blasted cities, displaced people of all ages, dreary work in grey offices, there was little respite for a young woman whose cinema-fed dreams were of passionate love rather than following the safe, prescribed road to marriage and children.

Byford’s mother is long-engaged to a doctor who never joined the Nazi party, worked as a medic in the war, but is then forced to practice in a hospital far from her. Lonely, sad, but aware of her sexual capital, the fetching young woman in her 20s starts an illicit affair with her much older boss, who is married with four children.

Sitting alongside the 1950s affair and its dramatic but long-secret outcome, is the modern-day, British-based psychotherapist’s daily routines and imaginings. Widowed with grown children and grandchildren, she is happy and proud of her professional life. But, like her mother, she finds herself drawn to someone unsuitable, a young woman who plays in an orchestra, one of her therapy clients. The struggle with these feelings is only ended when the therapy is complete and “like a drinker emptying bottles into the drain, I put her file away funder “past patients”. I block her Instagram account. I delete her number and email address on my phone.”

This fictional attraction contrasts with the real coupling of Byford’s mother and her boss. Her decision to keep the affair secret from the doctor whom she married mirrored, writes Byford, “what was going on around them after the way. There was a whole nation unable to talk about something that had happened at their hands… They settled for a version which had a few monsters and millions of relatively innocent followers.”

As she concludes, “My mother kept this secret and enforced the silence about it. She did not want to see it, and she did not want to hear it. Maybe she could not.

“Germany, my pale mother, with your secret and your shame and your long-lasting inability to talk about it. I look at you in those years, across the sea from the shores of a different country, after a long life, and I feel like weeping for us both.”

We have not chosen a book like this as a Welldoing recommendation before, but its psychological depth convinced us. The balance of the historical and modern stories is so well achieved, and for anyone interested in therapy, getting inside a therapist’s head is intriguing.

Welldoing Book of the Month September 2026: A Dance of Mirrors by Annette Byford

Book of the Month: A Dance of Mirrors by Annette Byford

Ari Sotiriou

There are some clear, relatively straightforward reasons that might prompt you to consider whether you are seeing the right therapist. They sit within the ethical and professional frame of therapy:

But simply feeling discomfort in therapy isn’t necessarily a bad thing.

, disappointment, feeling misunderstood, dependency or fear of dependency, feeling exposed, being challenged, experiencing painful feelings more intensely, and even wanting to leave therapy are not automatically signs of bad therapy.

Such things can be productive discomfort. Something difficult has happened, but it can be spoken about and thought about with the therapist.

One of the aims of therapy is to create some space between a feeling and the reaction to that feeling. Rather than immediately acting on anger, fear, hurt or rejection, we try to become curious about what has been stirred up.

If the answer is yes, and the discomfort can be explored together, there may be something therapeutically valuable taking place.

If the answer is no because the therapist becomes defensive, punitive, dismissive or insists that the patient’s experience is simply wrong, that is much more concerning.

The healthiest therapy is not therapy without ruptures. It is therapy in which ruptures can become thinkable.

Therapists inevitably misunderstand things. They may say something at the wrong moment, fail to appreciate the significance of something, or simply not understand part of the patient’s world.

That does not automatically mean the therapy has failed. Rupture is not necessarily evidence of bad therapy. The capacity for repair is one of the tests of good therapy.

The important questions are whether the patient can say: 

And whether the therapist can remain curious rather than defensive. A good therapist should be able to consider the possibility that the patient may be right.

When psychological theory becomes a problem

Concepts such as resistance, projection and transference can be extremely useful, but they should create more curiosity, never less.

I don’t think this therapy is helping and I’m considering stopping,

 it is possible that fear, dependency or resistance is part of what is happening. But that should be the beginning of an enquiry, not the end of it.

The concept of resistance becomes dangerous if it is used to make the therapist impossible to challenge.

If every criticism of the therapy is interpreted as evidence of the patient’s pathology, the therapist has effectively created a position from which they can never be wrong.

A therapist occasionally saying something about themselves is not automatically inappropriate. A completely impersonal therapist can sometimes feel just as difficult.

Does knowing something about the therapist help the patient think or feel more freely?

Or does the patient increasingly find themselves listening to the therapist’s problems, reassuring them or looking after their feelings?

If the patient is having to care for the therapist, the relationship has begun to move away from its therapeutic purpose.

Misunderstanding by itself is not necessarily a reason to leave. In fact, misunderstandings are inevitable in any sufficiently important relationship. What matters is what happens next.

I may have misunderstood you — help me understand 

is very different from a therapist saying, 

I know what you really mean better than you do.

Getting something wrong is human. Being unable to entertain the possibility that you may have got something wrong is much more concerning.

Therapy can sometimes bring painful feelings closer to the surface, so a temporary increase in distress does not automatically mean that the therapy is harmful.

Therapy makes you worse before it makes you better 

should never be used as a blanket justification. If someone’s wellbeing is deteriorating substantially or persistently, that deserves active clinical attention.

Therapeutic change is not linear, and some therapies — particularly longer-term psychodynamic psychotherapy or psychoanalysis — may unfold over several years. Periods of apparent stagnation are therefore not necessarily evidence that nothing is happening.

should always be available for thought. If patient and therapist cannot discuss whether the treatment is still useful, that itself becomes concerning.

 is absolutely the right thing to do. Sometimes the form of therapy is no longer appropriate, or someone’s needs have changed.

But a therapeutic relationship is also a relationship, and endings matter. Rather than simply disappearing or immediately replacing one therapist with another, when circumstances allow, there can be value in making the ending conscious.

A good ending may involve looking back at:

The ending itself can become part of the therapeutic work. Feeling uncomfortable in therapy is not automatically a red flag. The red flag is when the discomfort cannot be questioned, discussed or thought about.

What to Do if You Feel Uncomfortable With Your Therapist

Gemma Grainger is a welldoing.org therapist

Gemma Grainger

Recently I have noticed a trend in the number of people feeling really emotionally hurt by their employer and their workplace. The topic that seems to be bubbling over in the form of a societal 

 froth is AI and job loss. The headlines about AI ambitions, as well as current progress have left some professions somewhat redundant already. Additionally, in the last few years the rates of redundancies for companies needing to save costs has soared. There is a lot of fear and loss of self worth rattling underneath polished and confident CV’s, masks of established skillsets and positive affirmations.

Even the psychotherapy profession has been challenged by the mass use of the new favourite therapist ‘Chat’ (GPT), but as someone who lost her first job to sudden liquidation of a company, I empathise and relate deeply with some of these feelings, and fears that are, sadly, not irrational.

When a company’s financial security is in jeopardy, one of the earlier things I notice that changes is the company culture. This could be due to a merger, fear from senior level and pressure from financial level which trickles down. Like children to scared parents, employees sense change and nervous energy rises. Also, maybe perks will start changing or disappearing. Hours might become longer, job roles might expand or be redirected. Basically, chaos behind the curtain ensues while on the floor, managers attempt to act like all is fine.

I hear this from clients who talk about the ‘good times’ where everyone would work hard on a project and celebrate a long day with a game in the office or drinks after work. They didn't dread coming in in the morning because morale and even friendship was high. Without explicitly naming it, we build a positive attachment to our workplace as a component of our lives that we are in relationship with, and makes us feel positively.

This noticed and/or felt change I see might result in a melancholy, even a grief for what going to work used to mean on a day-to-day level, or a purpose or meaning level. 

The workplace started as a decent way to spend your day in order to earn a living. And now, it’s a pressure cooker, perhaps hostile, less engaged and a less human-centric experience. Sometimes we don’t notice how much impact a workplace environment can have on our general mood and wellbeing until it has gone downhill. I see this happening a lot.

The grief in itself is difficult to work through and accept or do something about, but it also raises

A good friend of mine found herself eventually in a new job after hopping in and out of a couple of short term contracts. She finally felt a sense of ease and optimism. This had all come off the back of being in a job for 10 years where she felt valued but slowly and surely the company made the majority of the workforce redundant, outsourcing work to India. I was so relieved when she told me she was enjoying work again and grateful to be working with a nice manager who was already talking about extending the contract. But then – just like that – she had a month left.

This is one in many such stories where people have had the rug pulled from under them. The loss of stability is huge, and in a very challenging job market, it doesn't come backed up with self-confidence that the next job is just around the corner. ‘One door closes another door opens’ mindset does not apply here!

Something that has really struck me working with people in such situations is the plummet in self-worth. How can an employer who gives you consistent praise and positive reviews all of a sudden not think you’re needed there anymore?

 and styles. We build secure attachments which in turn promotes a more secure understanding of ourselves in the world. This occurs relationally through reliable responses (“that wasn’t great but I still appreciate you”; “I may not always be at your side but I will come back”), consistent availability and appraisal, and this action from workplaces actively destroys that. In some people I would say this sudden rejection can create a trauma response. Think about it, “I am appreciated, I am valued, I am safe”. All of a sudden, “I am not important, I was an idiot to think I had that value and I am not safe”. Furthermore, the professional guise means that companies and employers are not often honest and transparent, which leaves people disorientated and confused, which then takes them much longer to recover from the whiplash and rejection.

When suddenly a job turns its back on you or the culture suspiciously changes, people can appraise it differently. There will be an individual difference here with some people giving the company the benefit of the doubt for a long time, while others spark straight into anger and self-protection.

Once a client has appraised that there is actually some blame to be placed, feelings of hurt can be channelled into anger, They say anger is the outward expression of sadness after all. These feelings can be challenging to sit with and know what to do with. Sometimes the ‘fight’ component can be helpful in leveraging self worth in order to move forward with assertion. On other occasions a client might stew in bitterness, betrayal, again, coming back to a broken attachment, which challenges their self worth and might even feel stuck and abandoned. It is a very difficult thing to have a relationship damaged in such a way, and going forward in the world, just like when you have had infidelity in a relationship, can manifest in a projected mistrust and cause long lasting impacts on roaming the world with ease.

Above I have summarised some of my key observations of when the workplace turns its back on my clients and friends, and all have connected but varying impacts emotionally and psychologically. It is hard to know what to do as a therapist that can be helpful and realistic. I have always struggled with giving psychological advice in this territory because business just isn't humanity. It tries to be, sure – but it isn’t. At the end of the day, money will always be the most important thing, not feelings.

I encourage my clients to think of their ‘pillars’, these are components that make up our lives and hold us up. Family, friends, a relationship, creativity, music, hobbies, travel, community. Work and/ or career will likely be one of them as they do give us stability when they are functioning well, just like all of those listed do. When one or two pillars are crumbling and need some renovation work, we need to reinforce the others even more so. It is dangerous to have our self worth tied up predominantly in one or two places. Distribute it, find ways to not only spend good quality time, but also to make us feel good about ourselves. I encourage clients to find ways of evoking feelings like; I’m not half bad at painting, or, it’s great to be part of a team that has so much fun together, or I can tell this friend really feels safe confiding in me.

Being realistic, finding work is hard, and now at the moment, from my angle, keeping work is hard. And we need income more than ever. But this isn’t just one client. Sometimes a bit of perspective is helpful. Even though their manager might really like them, at the end of the day, the business is puppeteering them. Sadly we don’t have that much control, but with that, I encourage clients to let go. Consider loyalties and pillars.

When Your Job Stops Caring About You

Lisa Daitz

If you're a keen gardener, or you just enjoy noticing nature and the changing seasons, October will already hold a place in your heart. It's a time of change, when the sap stops, the temperature drops and the colours herald a new stage in the seasons and in the year.

For many of us, it also marks the time to slow, down, take stock and re-group. And with that, comes the opportunity to re-set and to start to ask the bigger questions about how we are living and the changes we would like to bring about as we face the coming year.

Whilst some view autumn as the end of the year, for many of us it will always be associated with a time that heralded new starts, renewed promises and potential. And with that comes the chance for new ideas, new journeys, new beginnings and, yes, new year's resolutions.

As a psychotherapist, I know that once the summer months come to an end, I will always see an increase in calls as people recognise that the time is right to begin their therapy journey or to visit therapy again. For me, it is an exciting and optimistic time when I hear from people who are taking stock and recognising that they need to make changes. Therapy gives us the opportunity to work with challenges and issues, to make sense of them, to recognise choices and enable the opportunity to make the changes that many seek.

This year, as we move into autumn, I know that the idea of change is particularly topical and concerning. With change, inevitably comes uncertainty and now more than ever, that is striking a chord. The war in Ukraine, rising mortgage rates, the threat of cutting benefits and the dramatic increase in energy prices have forced many to take stock and face real stress and worries. And with the death of Queen Elizabeth, the foundations that often seemed to underpin the country, are feeling shaky for many people in this country.

Wherever there is change and transition, there is anxiety. Fritz Perls' describes anxiety well when he says that it is not knowing whether we will get applause or rotten tomatoes. Right now, many of us are not sure what the future holds and that, inevitably provokes anxiety.

October is the time to 'close the year': to review, reset and look forward. Whilst we plan the future, we stand in a paradox as we try to plan in an uncertain world. Support in therapy can be invaluable in trying to make sense of what we facing. It's an opportunity to explore each client's challenges and issues and the sense they make of them.

We take the 'ball of wool' that is anxiety and gently pull at each strand. We loosen the strand and we get some space. And we follow each strand to the end, making sense of the challenges, the anxieties and overwhelming feelings they may bring. It's an exciting process and one which allows us, with better understanding, to see choices and the possibility for change. It's also a process that explores how we can manage anxiety in an increasingly uncertain world.

For gardeners now's the chance to look out and review the year. Which plants have prospered, given joy and done well? Which have dwindled? Which haven't worked? And after taking stock, we look forward, asking what changes do we want to make over the next year? For many of us, the autumn marks the same moment. A moment to regroup and consider what's gone before and then to look forward and think about what comes next. Whilst this year may feel particularly challenging, therapy, like gardening, offers a optimism that despite the difficulties we face, we are planning for the future and we continue to be a work in progress.

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