Saul Hillman is a welldoing.org therapist in London

Saul Hillman

I have spent years sitting in academic spaces where 

executive functioning, dopamine pathways, emotional regulation

. I have spent just as many years in therapy rooms, sitting alongside people whose diagnosed or undiagnosed ADHD is quietly, and sometimes not so quietly, constraining their lives, often without the understanding or support they need in the spaces they inhabit.

More recently, in the aftermath of a generation-defining 

, there has been a growing tendency to dismiss ADHD altogether and to explain it away as a by-product of lockdowns, smartphones, or aspects of “modern life”. At the same time, ADHD has become increasingly visible in popular culture: celebrities self-identifying, characters written into television dramas, viral content promising quick recognition or dismissal. With visibility comes knowledge but will also bring with it scrutiny, scepticism, and judgement. It is a double-edged knife.

I sit in all of these conversations not just professionally, but personally. I recognise parts of myself in them. I may well be one of the many undiagnosed adults whose behaviours invite assumptions. And I am also a parent to a young person with ADHD, and I watched those same misconceptions attach themselves early, shaping not only how they were perceived by others, but how they began to see themselves and what they believed might be possible for their future.

It is not about laziness, stupidity, and certainly not a form of madness. There are countless articles now suggesting we are in the midst of an ADHD overdiagnosis crisis. I would argue the opposite: what we are seeing is the long-delayed correction of a massive underdiagnosis. That doesn’t mean every diagnosis is perfect, nor that every difficulty stems from ADHD — and that isn’t the point. It is a distraction. I’m also not naïve enough to suggest the pandemic didn’t unsettle something fundamental, or that excessive social media use doesn’t mimic some ADHD-like symptoms. We simply don’t yet know enough. But uncertainty should not be weaponised to invalidate people’s lived realities.

This piece isn’t intended to be an academic treatise. At its core, ADHD is a neurodevelopmental difference that affects how the brain regulates attention, motivation, emotion, and action. People with ADHD often know 

 they need to do — but struggle with starting, sustaining, prioritising, or switching, particularly under pressure, overwhelm, or perceived judgement. Over time, these struggles don’t just remain practical; they become deeply emotional and internalised.

One of the most painful patterns I see — regardless of whether I am wearing my therapist, academic, or parent hat — is how quickly people with ADHD absorb other people’s misunderstandings. Children learn early that if they cannot begin, complete, or maintain effort in the way expected, the explanation offered is usually moral rather than neurological. They leave formative moments with explicit or implicit messages that they are lazy, careless, unmotivated, not trying, stupid, or “a bit crazy”.

By adulthood, the external critics are no longer needed. The internal voice has taken over. 

 helps us understand why this happens. ADHD brains show differences in how they filter distractions and regulate dopamine, which plays a central role in motivation and reward (Osborne et al., 2023; Morsink et al., 2021). Research consistently shows that adults with ADHD experience higher rates of shame, low self-. esteem, anxiety, and depression — not because of ADHD itself, but because of years of negative feedback, misunderstanding, and unmet expectations (Ginapp et al., 2022).

This leads to one of the most misunderstood — and most dominant — features of ADHD.

When information, emotion, or choice becomes overwhelming, the system can shut down. From the outside, this looks like avoidance, procrastination, or apathy. From the inside, people describe it as being trapped and stuck, fully aware, wanting to move, but unable to make mind and body align. This is not laziness. It is overload.

Similarly, the emotional intensity associated with ADHD is often misinterpreted as instability. Being “too much”, “overreactive”, or “crazy” becomes the label, rather than recognising a nervous system that processes emotion with less filtering and more immediacy.

Across all my roles, I have become increasingly committed to the power of naming what is actually happening. If everything feels too much, saying “my brain is overwhelmed” is not an excuse — it is information. Many people with ADHD struggle not just with functioning, but with explaining 

 they function differently. While it is not anyone’s job to educate the world, it can sometimes be helpful to frame ADHD in terms of executive functioning, attention regulation, and prioritisation — not effort or willpower. Research on stigma shows that reframing ADHD as a neurodevelopmental condition rather than a behavioural problem reduces self-blame and psychological distress (Elnageeb et al, 2024).

There are also many practical strategies that can help scaffold the ADHD brain: body doubling (i.e. a person completes a task while another person is quietly present), breaking tasks into smaller steps, reducing choices, building in movement, externalising reminders, and creating meaningful rewards. These approaches don’t “fix” a broken brain — they support a different one.

In every role I hold, I watch people with ADHD navigate a world that still largely misunderstands them. This is not unique to ADHD; it extends to many neurodivergent and mental health experiences. The issue is rarely the individual. It is the assumption that difference equals deficiency.

ADHD does not mean you are lazy. It means your brain needs different conditions to thrive. The real harm doesn’t come from the difference itself, but from years of being told you should function as though that difference doesn’t exist.

Elnageeb, M. E., Ahmed, E. M., Adam, K. M., Edris, A. M., Ali, E. W., Eltieb, E. I., ... & Eleragi, A. M. (2024). Interdisciplinary Insights and Global Perspectives on ADHD in Children: A Comprehensive Bibliometric Analysis (2014–2024). 

The lived experiences of adults with ADHD

I’m Not Lazy, Mad or Stupid: Debunking the Myths of ADHD

Claire de la Varre

Last year, before embarking on a four-day hike on Heaphy Track on the South Island of New Zealand, my boyfriend surprised me by taking me to Mariua Springs mountain spa. 

We soaked in the hot springs, walked around in bathrobes, had cocktails and dinner in the resort, slept like babies, and early the next morning, just after sunrise, we went to the Japanese bathhouse. It was quiet and peaceful, with sunlight streaming in, and no one else around.

We bathed in the pool for a few minutes and then spontaneously moved so that we were leaning back-to-back against each other. The pool was a little too deep to sit down in, and I positioned myself somewhat like a ballerina doing a deep curtsey: arms outstretched, head bowed, with one leg crossed under me and most of my weight on the other foot. It sounds uncomfortable but it wasn’t, as the water was supporting me.

My boyfriend leaned back so that his head was resting on the back of my neck and he was slightly reclining. We stayed like that, completely still and without speaking, for over 10 minutes, only moving when other people started drifting into the bathhouse. Later, he said, 'It felt as though our nervous systems were connected'.

That comment eventually led me on a deep dive into 

, a term that I have only recently come across. (1)

Interpersonal neurobiology was developed in the 1990s by Dr. Daniel J. Siegel, now Professor Emeritus of Psychiatry at the UCLA School of Medicine. 

This interdisciplinary field draws from research into emotions, cognition, neuroscience, evolution, anthropology, sociology, comparative anatomy and developmental psychology. It allows for a deeper and more expanded understanding of the brain, the mind, and human relationships.

It should come as no surprise to learn that what we say and do can affect others at a deep level — and vice versa. We all experience that reality every day and probably take such an extraordinary thing for granted. We humans, through our brains, seek to self-regulate and regulate those around us. This is known as 

We know what to say and do to soothe our children. We know which toes will hurt, so to speak, if we step on them when we are arguing with a spouse or partner. We know that a hug or a compliment from someone we love goes a long way, making us feel secure, or inspiring us.

We can join a crowd and get caught up in the energy and the vibe — whether listening to music at an outdoor concert, attending an ice hockey game or a religious ceremony, or taking part in a protest march or a Black Friday shopping spree.

We have individual brains that also function as social organs, wired to be part of a family, a crowd, a tribe, a group, a throng, a clan, a herd.

We know the rules in a group: there are unspoken rules for how to behave whether at a PTA meeting, in the supermarket, at a football game or at a wedding or funeral. We cooperate, we accept or reject, we judge, we are altruistic or selfish, we consider pros and cons.

There are behaviours that are acceptable and normal, and others that are outside the agreed parameters and are frowned upon or laughed at. We have codes of ethics, rules, and regulations. Some behaviours are punishable by law. Language allows us to develop effective tools of social control. We have police forces and other professionals to keep an eye on us and enforce good citizenship.

These moral and legal codes differ between cultures and societies and may lead to different expectations, as well as misunderstandings, violence, and war. We may experience (sometimes conflicting) loyalties at multiple levels as we grapple with meeting our own needs and the needs of those with whom we are allied.

Communication within groups and between people occurs at multiple levels and happens all around us all at the same time. We process cues, quickly and unconsciously, that tell us who is in our group or tribe and who is an outsider.

Evolutionary research shows that compared to our closest primate relatives, chimpanzees and bonobos, humans have evolved to be much less aggressive to members of our tribe or in-group, and more likely to go to war against outsiders.(2)

Our languages, and the words that we speak, are delivered in a huge variety of tones of voice, accents and dialects. We may use sarcasm or humour that alters their perceived meaning and is intended to be understood only by a select “in-group.”

Visual input, or what we observe with our own eyes, includes what is conveyed by clothing, hair styles, skin colour, piercings, tattoos, jewellery, colours, shoes, accessories, facial expressions, micro expressions, eye and eyebrow movements, blinking, laughter, tears, sighs, groans, gestures, touch, personal space, eye contact, the set of the jaw, how we walk, the position and movement of arms or legs, or aggressive behaviours.

The non-verbal messages say: I am powerful. I am submissive. I am scared. I am invisible. I have money. I am one of you. I am not one of you. I am homeless. I like this kind of music. I like this kind of sexual partner. I don’t like myself. I don’t like you. I am depressed. I am happy. We’re in this together. I am insane. I will hurt you. I will take care of you. I am old. I am a child.

Cues alert us to whether someone in the group is ill or infectious with something potentially life-threatening and therefore to be avoided e.g. skin rashes, runny noses, open sores, coughing or sneezing, blood, vomit, holes, or missing or malfunctioning body parts. These all scare us on some level.

We signal to others by universal facial expressions like disgust, or a sudden intake of breath, a laugh, or a scream. We blush or stick out our tongues. We kiss. We point, clap, whistle, and shout. We stamp our feet and chant or sing. We may start to run without even knowing what we are running away from or towards. Fear takes over, or laughter, anger or hatred.

So how do our social brains do, perceive, and process all of these things?

As humans, we interface with other people, and when we receive and transmit information verbally and non-verbally, this is analogous to the transmission of energy and information across the synapses (junctions) between neurons (nerve cells). This 

 allows us to link our brains to others’ brains.

When we are functioning well, in a state of well-being, the various parts of our brain function as a balanced and harmonious whole. This is called 

 fire off when we watch or witness someone’s actions, as though we ourselves were performing them. These enable us to not only understand another’s intentions, facial expression, tone of voice, and therefore emotions, but to feel in the body what it is like to be engaged in those behaviours. This is a factor that allows us to learn by watching, mimicking or copying another person. It also allows for the development of theory of mind — the recognition that other people have minds and can think and act with intent, just as we can.

Interestingly, if something interferes with our mirror neurons, like an injury that paralyses facial muscles, or even botox for cosmetic purposes, our ability to discern the meaning of facial expressions in others is affected.(3, 4)

We have attachment systems, with mechanisms and chemicals for bonding with our caregivers, family members, and intimate partners — endorphins, oxytocin, vasopressin, dopamine, and serotonin.

We can observe the mind and the workings of the mind with a detached awareness that can be cultivated through practices like meditation. We all have the ability to do this — to not only recognise that we know something, but to recognise that we are the knower, a reflective and observing self.

 in interpersonal neurobiology is very specific i.e. the mind is not simply the result of neural activity in a single brain but describes what emerges through connections to others, in relationships, within the context of culture or society. The mind is therefore a product of not just the individual’s nervous system, but the extended nervous system created by the interaction of two or more people.

So, next time you put your arm around a friend, pat a buddy on the back after a game, kiss your lover, or calm down an anxious child, notice what happens, in you and in them. Perhaps you are an 

The Goodness Paradox: The Strange Relationship Between Virtue and Violence in Human Evolution

Birch-Hurst, K., Rychlowska, M., Lewis, M. B., & Vanderwert, R. E. (2022). Altering facial movements abolishes neural mirroring of facial expressions. 

Cognitive, Affective, & Behavioral Neuroscience

Hennenlotter, A., et al. (2009). Botulinum toxin-induced facial muscle paralysis affects amygdala responses to the perception of emotional expressions: preliminary findings. 

Why therapy works: Using our minds to change our brains (Norton Series on Interpersonal Neurobiology)

an adult and a young boy gentle touching hand to hand

Interpersonal Neurobiology: How We Are Wired for Social Connection

Dr Alina Kastner

Alice McGurran

Asking yourself whether you’re involved with a narcissist is a scary place to be. You are probably feeling very alone with some unanswered questions in your head right now. My mission is to help you answer most of those questions. I have been in your shoes many times before and know exactly what it feels like. 

Even though I dedicated a lot of time to the topic of narcissism, I was not safe from its heartbreak. The pain from these relationships motivated me to learn everything I could about narcissism and help others around the world avoid going through what I did. It pushed me to become a psychotherapist, focus on couples and spousal abuse, and even write a two-hundred-page PhD dissertation on narcissism.

Despite my knowledge of narcissists at the time, I was still deeply hurt by them. 

I’d love you to be able to trace back what has happened with narcissists in your past, understand what is going on with the narcissist in the present, and figure out how to deal with leaving the narcissist going forward. This is exactly what I set out to do with this book. I want to arm you with all the knowledge and emotional preparation you need for this war and give you the necessary wisdom, guidance, and confidence to end it. You can break free and stay free from narcissistic partners forever.

In the very beginning, your narcissistic partner may have felt like a little piece of paradise — like your soulmate. What has truly happened: They lured you into their narcissistic web to manipulate and abuse you. You’re experiencing feelings of confusion, hurt, betrayal, and possibly even severe depression, but healing is possible. 

It’s hard to believe, but if you have a little faith in yourself and this process, even if you’re not feeling it right now, you will grow stronger through this heart-wrenching experience and your hard work will pay off.

Watch our interview with Dr Alina Kastner:

burning paper heart

Breaking Up with Narcissism: How to Protect Yourself

Jamie Laing for Welldoing

Jamie Laing

I went to a guy called Mark. I sat down in his office, and he asked what was going on. It was like word vomit came out of me. I got very emotional and very upset. I told him everything – from the very first panic attack, to how I had been feeling, to the extent of my 

 to try to suppress how I was feeling, to the dream state I now found myself in, to being up and down and never telling anyone, to feeling judged by people, to being worried about coming to therapy sessions because I was worried about what I would talk about and that I was such a people pleaser that I would have to make him like me.

‘Don’t worry,’ he said at the end of the session. ‘This is going to be super easy.’

‘What do you mean, super easy?’ I replied. I mean, this felt nothing like a super-easy task.

‘Jamie, you are not complicated, and this is not a complicated problem,’ he explained calmly. ‘You think it’s complicated. You’re just having a really tough time. If you come back next week and the week after and the week after, we can get through this together.’

It was a real lightbulb moment, one which made me change my attitude. I did go back the week after, and the week after that: in the end I saw him for about six or seven months in total. Mark was the one who explained what anxiety is and what I was going through. We talked about how it could be linked back to my childhood and to the concept of rejection, rooted in the way I was sent off to boarding school when I was so young, with my parents divorcing and us moving away from the home I knew and loved in the very same year. He taught me to understand myself and to be more self-aware. He encouraged me to reconnect with my family. I started to be much kinder, both to myself and the people around me.

He was the person who told me if I took care of the little things, the bigger things would fall into place. When I first started seeing him, my life was in utter chaos. Bills went unpaid, my flat was a disaster; clothes lay everywhere except in my wardrobe, and I never knew where anything was. In my mind, all these tasks were incredibly dull. If something didn’t excite me, I simply wouldn’t do it. I was constantly chasing a dopamine hit, always looking for excitement.

His advice was simple. He told me to make my bed in the morning, put my toothbrush back in the same place, put my post in the right place, hang my jacket up when I come through the door, pay that bill that I never pay, turn the TV off ... if I did those small things, then some of the larger issues in my life would resolve themselves, and it’s so true. It’s one of the most valuable pieces of advice anyone has ever given me. I had to retrain myself and understand that it is precisely those mundane things that are most important. It means that you don’t live with the constant worry about procrastination, and it made a huge difference. 

But now I suddenly had another issue: now that I felt much better and things were back on track a bit more, I thought I was cured. My 

 had lifted, I thought I understood myself better, and I felt good. ‘I’m cured of this thing called anxiety,’ I told myself. ‘I’m absolutely fine.’

One week, I just didn’t rebook to go back. A bit like a break-up, we just stopped seeing each other. He couldn’t force me to return, and for me, it felt like the time had come to move on and that this chapter of my life was firmly closed. 

Things started to slide further. Old feelings and habits began to creep back in even more than before. I started to feel confused and unwell again. One day I found myself listening to a podcast where the person being interviewed said that they had been doing therapy for eight years, and it had changed their life. I then Googled famous people who had done therapy, and there were hundreds. Hundreds and hundreds. This was almost the norm.

What I soon realised was that therapy and working on yourself is a constant thing. It’s like going to the 

. When I stopped talking and working on myself, and doing all the right things, old ways crept back. I realised it’s not something that you can pick up and drop at will. It was like learning a new language. The moment you say you don’t have time for something like therapy is exactly the time that you should make the time.

I decided to find a new therapist. With Mark, helpful as he had been, our exchanges had been more clinical – he was the therapist, and I was the client, and sometimes it felt a bit like a job, almost transactional. And for someone like me, who is so driven by their emotions, I wanted more of a connection. I now wanted something deeper, which showed how much I was now ready to do the work I needed to do.

I was recommended Mal, and from our very first meeting, it was clear it would be different. It was the beginning of weekly therapy sessions for four years. We continued through lockdown, and it was the best investment that I have ever made. 

I never cancelled a session with Mal. This time, I treated my weekly therapy like a job. It took a lot of effort – there were countless times when I didn’t want to go, especially at the beginning. My sessions were on a Monday at 8am, and I spent many Sundays brainstorming excuses to skip the next day’s appointment. I felt totally drained after each conversation, even though I hadn’t started my day, so there was that too. Yet I knew that I had to keep going with it. I had tried to solve things myself, and it hadn’t worked. I made a deal with myself that I would see it through.

Therapy demands a lot of self-discipline. It’s not just about showing up, because for it to work you have to actively put in the work once you’re there. I was in a position where I wanted to better myself, and that was my driving force, a North Star guiding me forward. A reason why I started doing my initial therapy with Mark was that I wanted to feel better, and I believed, once my anxiety had eased and when things were looking up, that I had reached my destination.

But then, my North Star shifted. It was not just about feeling better in the moment or for a period of time. I wanted to be a better person. Dealing with my anxiety was a big one, but I wanted to be more self-aware and understanding of myself, my family and friends. I’m still chasing that goal.

Therapy requires a long-term commitment, but it’s well worth the effort. It forces you to confront difficult truths and unpack old patterns. You commit to consistent 

 and hard work and you often see progress in small, incremental steps rather than dramatic leaps. This journey of self-understanding and personal growth requires time, patience, and unwavering dedication. I now understand you don’t ‘finish’ therapy; you integrate its lessons into your life. It’s a tool I plan to consistently engage with, a continuous investment in my mental wellbeing, and a commitment to personal growth. You build your best self over the years, not in a day.

Jamie Laing: "Therapy Demands a Lot of Self-Discipline"

Gilead Yeffett

Have we become obsessed with fixing our relationships? We consume advice columns, listen to podcasts about communication strategies, and read books promising to decode the mysteries of human connection. We treat relationships like problems waiting to be solved, as if the right technique or insight will finally make everything click into place.

But relationships aren't problems. They're experiences.

The compulsion to "solve" a relationship often stems from discomfort with its natural messiness. When conflict arises, when miscommunication happens, when someone we love disappoints us, our instinct is to reach for a solution. We want a framework, a strategy, a way to ensure it never happens again. We want control over something that is fundamentally uncontrollable: another person's inner world colliding with our own.

This solution-seeking mindset creates a strange paradox. The more we try to perfect our relationships, the less present we become in them. We're so focused on optimising, analysing, and strategising that we forget to simply 

 with the person in front of us. We miss the small moments—the ones that can't be engineered or replicated.

Living a relationship means accepting its fundamental uncertainty. It means showing up even when we don't have the right words. It means sitting with discomfort instead of immediately trying to eliminate it. It means recognising that some tensions won't ever fully resolve, and that's not a failure — it's just the reality of two separate people choosing to intertwine their lives.

This doesn't mean we should ignore genuine problems or accept toxic behaviour. There's a difference between living a relationship and merely enduring one. But many of the things we rush to "fix" aren't actually broken. They're just difficult. They require patience, presence, and the willingness to remain engaged even when things feel uncertain.

The most profound relationships aren't the ones where everything runs smoothly but the ones where two people commit to staying present through the awkwardness, the confusion, and the inevitable disappointments. They're the ones where both people understand that the relationship isn't a project to complete, but a continuous act of showing up.

So perhaps the question isn't "How do I solve this?" but rather "How do I stay present for this?" The answer won't come from a book or a framework. It comes from the daily, unglamourous practice of living alongside another person — imperfectly, honestly, and without the promise of a perfect ending.

What does "showing up" really mean? It's not grand gestures or perfectly timed interventions. It's answering the phone when we'd rather be alone. It's listening without preparing our rebuttal and needing to win the argument. It's choosing to stay curious about someone even after we think we know everything about them. It's the willingness to be changed by another person, to let them matter enough that their presence reshapes us.

Perhaps what we're really seeking beneath all those solutions isn't perfection at all — it's acceptance. What we want, and what our partners want, is to feel truly accepted: messy thoughts, inconvenient emotions, and all. 

We want to know that someone sees us clearly, with all our contradictions and flaws, and chooses us anyway. We want the freedom to be uncertain, to change our minds, to have a bad day without it becoming a referendum on the relationship's viability. And we want to offer that same gift to our partners: the permission to be human, imperfect, and still entirely worthy of love.

The irony is that our obsession with fixing creates the opposite effect. When we're constantly trying to improve or correct our partner, we send the message that who they are right now isn't quite enough. And when we're endlessly optimising ourselves to be the "perfect" partner, we deny them the opportunity to accept us as we actually are.

So how do we live a relationship rather than solve it? We can begin by noticing when we're reaching for control — when we're trying to engineer an outcome rather than experience a moment. We can ask fewer questions that begin with "How do I make them..." and more that begin with "How can I be present for..." We can let go of the fantasy that perfect communication will prevent all misunderstandings. 

Above all, living a relationship is a practice, not a destination — one that asks not for perfection, but for our honest, flawed, wholehearted presence, again and again.

couple at home in the kitchen

Have We Become Obsessed with Fixing Our Relationships?

Simina Simion

“If you truly want something with all your heart, you will find the energy and means to make it happen.” Those were my analyst’s words at a moment when I was close to giving up. I can still hear his calm, steady voice. I was lying on the same old couch, absent-mindedly tracing the embroidery on the throw with my fingers, staring at the ceiling. 

I had run out of patience. Powerlessness, fear, and frustration were rolling around inside me. My clinical training in psychoanalytic psychotherapy felt endless. After five years of seminars and assignments, years of intense analytic work with patients, almost two years spent in the corridors of a psychiatric hospital caring for those too unwell to be in the community, and hundreds of hours in personal analysis and supervision, I felt I’d reached the end of the tunnel – only there was no light. And the journey was not yet over. 

How was I going to see this through? How would I carry the cost, financially and emotionally, of such an arduous training? 

Part of me wanted to rage – at the universe, at my training organisation, at my analyst, and most of all at myself for choosing such a complex and lengthy path. And yet I knew I could not quit or turn back. 

I was especially cross with my analyst: how could “wanting it” possibly summon the energy and the means? If I didn’t want to complete it after all those years, who did? 

What I couldn’t see back then – despite already being five years into both my analysis and my training – was that no one else could carry this for me, and I was not yet ready to step out of the safety of being a trainee and take on the full responsibility of standing alone in the world as a psychotherapist. Becoming a therapist is not just an academic pursuit; it is about being prepared to hold the emotional and mental lives of others, which demands maturity, self-awareness, and inner readiness.

I already had a BSc in Forensic Psychology, and still so many questions felt unanswered. A fierce curiosity drove me: to inch closer to what felt true in me and to understand the human condition more deeply. That is why I committed to the long, demanding road of psychoanalysis and psychoanalytic psychotherapy.

So, what does psychotherapy training actually involve in the UK? 

Although programmes vary by modality and institute, the training is rigorous and postgraduate in level, combining theory, supervised clinical practice, and one’s own personal therapy. I can speak most honestly about the path I took: psychoanalytic psychotherapy and analytical psychology with the Association for Group and Individual Psychotherapy (AGIP) in London.

My clinical training took nine years in total, including a foundation year. Throughout those years I was in my own analysis – most often three times a week, and for several years four times a week. I still see personal analysis as the master teacher in my profession. I do not believe we can become good, ethically responsible psychotherapists, entrusted with another person’s inner life, without undergoing our own sustained process of self-knowledge. Truly knowing oneself happens in relationship: sharing one’s thinking and inner world with another and allowing oneself to be vulnerable and seen.

Alongside personal analysis, the training combined several strands:

It is demanding – of time, of money, of one’s capacity to think when it would be easier to react. It asks you to tolerate uncertainty, to stay with not-knowing long enough for something true to emerge. It requires humility: you learn quickly that techniques are useful, but it is the quality of attention, the steadiness of the therapeutic frame, and the depth of your own self-knowledge that become decisive.

Why do it? Because when someone sits in front of you, you are asked to think with them when they cannot; to help them make sense of what feels unbearable; to hold hope when hope is temporarily out of their reach. And it demands that we, as therapists, keep doing our own work too.

So, if you are considering this path, know that the journey will test you and shape you. The light at the end does exist, but it is not a spotlight of triumph. It is quieter and more human: the moment a patient says something they have never been able to say before. In that moment, all the years of study, observation, placements, supervision, and analysis make a different kind of sense. The training does not end but it becomes part of how you live, and how you listen.

scrabble tiles spelling out the word therapy with a key in the foreground

What it Really Takes to Train as a Psychotherapist in the UK

Kelly Hearn

January feels me with so much dread. I'm exhausted from a frantic holiday period and now I'm supposed to have the energy to become my 'best self ever?' I want to just crawl under the covers and emerge in March.

I would encourage you to listen to what your body is telling you: you're exhausted and need rest. The Christmas holiday period isn't a vacation for most - the heightened expectations and ensuing pressure; the competing family demands, the travel and related chaos; the sleeping away from own beds, or, if hosting family, HOSTING FAMILY. All on top of the usual December pre-holiday frenzy. No wonder you - and so many of us - are now utterly depleted. I wouldn't be the first to suggest the timing of Resolution Season is entirely misguided, coming as it does on the heels of all that activity as well as coinciding with the coldest, darkest, shortest days. That any amped-up jump-start to activity is completely out of sync with the hibernation seen elsewhere in nature.

I encourage all of us to update our approach to the New Year. Let's look at the root of the word resolution - from the Latin resolvere meaning to loosen, relax, set free. Can we set ourselves free from the idea of 'New Year, New You,' a myth totally at odds with reality NB: an estimated 80% of New Year's resolutions fail, many in the first two weeks of the year .

I am inevitably rebuffed when I suggest to clients a loosening of what feels like a 'critical parent' approach our culture takes to the resolution rigamarole. I am met with a pervasive fear that if we 'go easy' on ourselves we'll descend into sloth and lethargy. Sofas and ice cream are mentioned with surprising frequency. But the research points to the opposite. Dr Kristen Neff's work shows that those who take a harsh, critical approach towards themselves are much more likely to stay stuck, and to be anxious and depressed as they live from a place of fearing failure. By contrast, Dr Neff's work shows self-compassionate, nurturing people are more likely to stick to and achieve their intentions. These people don't go easy or soft on themselves. Rather they set high but attainable standards.

'Self-compassion allows us to acknowledge areas of personal weakness by recognising that imperfection is part of the shared human experience. We can then work on improving ourselves, not because we're unacceptable as we are, but because we want to thrive and be happy,' according to Dr Neff, echoing an oft-quoted but rarely lived offering from Carl Rogers: 'The curious paradox is that when I accept myself just as I am, then I can change.'

In giving up our impossible expectations, we become a lovingly connected self. We renounce ideal visions in pursuit of authentic ones. When we are able to do this for ourselves, we are able to extend it to others. We no longer wait for the perfect friendship, relationship, children, work, colleagues. We honour the sweet imperfections of humanity.

So as you consider how you approach the New Year, Grinch, I encourage this reframe. I invite you to turn your journal musings away from aspirations towards appreciations of what is already good and great about yourself and in your life. And to acknowledging and accepting even those bits you don't find so lovable or desirable. They are you, too. This is deceptively difficult to do, perhaps because a 'never enough' cultural ethos is so ingrained, leading to what can feel like a punishing, never-ending self-improvement project. Can we recognise that these beliefs and drivers are working against us recall that resolution failure rate and risk other ways of being?

Your body is telling you to get out of the resolution rat race already. If you follow this counter-cultural approach, you will likely find that desired changes evolve in their own time. Trusting the inherent human urge to grow and develop given potentialities leads to a much healthier-and more enjoyable - version of striving. We don't have to change, we get to. Lucky us!

Do you have a question for Dear Therapist? Send it to info@welldoing.org with Dear Therapist in the subject line and

Dear Therapist..."January Fills Me With Dread - Wake Me Up in March"

Harriet Frew is a therapist based in Cambridge who specialises in eating disorders and body image issues. She is currently working full-time for Cambridgeshire and Peterborough NHS Foundation Trust.

Harriet Frew

It's that time of year again, a brand new year waits, bursting with vibrant possibility and hope. It's a gleaming, clean slate for new beginnings.

This is the year to become the shinier, improved version of yourself, and with this in mind; you create your list of promising resolutions. Typically, these might include: losing weight; 

; getting organised or stopping smoking to name a few. You are optimistic and expectant. Never mind that you have set the same resolutions for the past few years.

January is a cruel time to inspire change though. The weather is cold and bleak; we are struggling financially after the Christmas splurge and summer feels a long time away. It is not surprising that New Year's resolutions are often broken six weeks in, when 

 has dwindled, mood is low and we are looking for creature comforts more than ever.

 and a whole bucket-load of good intentions isn't a recipe for sustainable change, without delving a bit deeper into these issues? If you're overeating or drinking too much as a coping strategy for unhappiness or stress, then how can you expect yourself to follow through on the resolutions when the winter bleakness becomes all engulfing? Alcohol, sugar, cigarettes, and the comfy, warm sofa are instant, effective short-term fixes to raise mood and offer escape. Is it not surprising that the hopeful plans fall by the wayside?

Instead, this year could be the time to work on these issues from the inside-out, so working on your mind and emotional wellbeing through counselling, and giving your body a fighting chance of achieving your goals.

For change to happen, you need to understand why you turn to food or drink or feel constantly anxious. Often, we are completely unaware of 

 we do things. It can feel confusing. On the one hand, we sincerely want to change. On the other hand, we seem to sabotage our efforts. This is usually because the thing we are doing is a coping strategy at least in the short-term . It might calm us down; offer soothing and distraction; it might also be a lasting habit.

Having counselling can provide a safe and non-judgmental place to unpick and make sense of these themes more fully. Once awareness and understanding is achieved, this provides a valuable springboard for change to happen.

The Christmas holiday offers a break for reflection and self-evaluation, where you can think about your values and areas for self-improvement in life. The start of a new year then can provide the impetus to consider change and step out of your comfort zone. You might feel a little braver and more open to considering alternative ways of managing change. Grasp this impetus by being brave and bold, and reaching out to a counsellor now before this burst of energy fades.

Counselling can sometimes feel like a complicated hassle compared to the shorter-term 'transformations' you might gain from a new diet or exercise regime. Unfortunately, counselling is not a quick fix, and you can feel worse before you feel better. Nevertheless, counselling can offer a valuable and lasting solution. It helps you develop awareness and psychological insight, along with improved strategies for change. This can mean new and effective ways of coping which can impact your relationships, work, resilience and self-esteem. With any luck, you then won't need to be making the same old resolutions again next year!

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