How I Work
Understanding complexity without reducing you to a label
People are complicated.
Our experiences, relationships, biology, nervous system, environment and ways of making sense of the world all interact. The things we think, feel, do and experience in our bodies can be shaped by many different influences, often over a long period of time.
Sometimes there is a straightforward explanation. Often there isn't.
You may have a diagnosis that explains some of what you experience but not all of it. You may have physical symptoms that are very real but haven't been adequately explained. You may understand intellectually why you respond in certain ways but still find yourself reacting automatically. Or you may simply know that something isn't working, without knowing exactly why.
I don't believe you need to fit neatly into a diagnostic category or a particular treatment model for your experience to be understood.
My starting point is curiosity.
What has happened? What has shaped you? What is happening now? What keeps these patterns going? And, importantly, what could be different?
Understanding before changing
Change is difficult when we don't understand what we are trying to change.
Before deciding what approach might be helpful, I want to understand your experience in context.
That may involve exploring your history, relationships, physical and psychological experiences, current circumstances, patterns of behaviour, ways of coping, strengths and the things that matter to you.
This process is sometimes called formulation.
For me, formulation isn't about putting you into another box. It's about developing a working understanding of how the different parts of your experience fit together.
A formulation can help make sense of questions such as:
- Why do I react this way?
- Why does my body respond like this?
- Why do I keep doing something I know isn't helpful?
- Why do I feel disconnected from myself or other people?
- Why do certain situations affect me so strongly?
- What might be connected to trauma, neurodivergence, learning or adaptation?
- What can I actually change?
The aim is to develop an explanation that is useful, compassionate and open to revision as we learn more.
Looking at the whole system
I don't see psychological experiences and physical experiences as separate worlds.
The brain, nervous system and body are constantly interacting with our thoughts, emotions, memories, relationships and environment.
This is particularly important when working with persistent physical symptoms, functional neurological symptoms, dissociation and trauma.
A symptom can be physically real without there being a straightforward structural explanation for it.
Understanding this doesn't mean saying that something is "all in your head". It means recognising that the nervous system, brain and body are capable of producing very real experiences through complex interactions between biological and psychological processes.
Where appropriate, I can help you explore these connections alongside appropriate medical care rather than treating psychological and physical health as competing explanations.
Trauma and adaptation
I work with people affected by trauma and overwhelming experiences, including complex and developmental trauma.
I don't think of trauma simply as something that happened in the past.
What matters is also what the experience taught your brain and nervous system about yourself, other people and the world.
People develop ways of surviving difficult experiences.
You might become highly alert to danger. You might learn to disconnect from feelings or parts of your experience. You might become extremely self-reliant, perfectionistic or accommodating. You might struggle to trust other people, regulate emotions or recognise what you need.
These responses often made sense in the circumstances in which they developed.
The difficulty is that an adaptation that was useful at one point in your life can become restrictive when circumstances change.
Understanding that distinction can create an important shift:
Instead of asking "What's wrong with me?", we can begin asking "What happened, what did I learn from it, and what is still needed now?"
Dissociation
Dissociation deserves particular care and attention.
For some people, experiences of disconnection, depersonalisation, derealisation, memory disruption or different self-states can be confusing or frightening. For others, dissociation has become so familiar that it can be difficult to recognise.
I work with dissociative experiences within their wider context rather than treating them as isolated symptoms.
This can involve developing greater understanding of why dissociation occurs, increasing awareness and safety, building the capacity to remain present, and gradually developing more flexibility in how different parts of your experience are managed and integrated.
Where someone has significant or complex dissociation, the pace and approach matter.
The aim is not to force experiences open before you are ready.
The brain and nervous system
I take a neuroscience-informed approach to understanding behaviour, emotion, learning, attention, memory and nervous system responses.
This doesn't mean reducing a person to their brain.
Neuroscience is one source of information that can help us understand why particular patterns may have developed and why changing them can sometimes be difficult.
It can help us think about things such as:
- Threat and safety
- Attention and awareness
- Learning and conditioning
- Memory
- Emotional regulation
- Automatic responses
- Habits and behaviour
- The effects of prolonged stress
- Neuroplasticity and learning
I use this knowledge to support practical change, rather than presenting neuroscience as a collection of techniques or promising that the brain can simply be "rewired".
Neurodivergence and Trauma
Neurodivergence and trauma can sometimes overlap in complicated ways.
Attention, impulsivity, emotional regulation, sensory experiences, relationships and patterns of behaviour can be influenced by neurodevelopmental differences, trauma, environment or combinations of these.
I therefore don't assume that every difficulty has one explanation.
For someone with ADHD, for example, the important question may not simply be "What are the ADHD symptoms?"
It might also be:
What is ADHD?
What is trauma?
What has been learned?
What has developed as an adaptation?
And how do these things interact for this particular person?
This kind of individualised understanding can be much more useful than trying to force every experience into a single explanation.
Different approaches for different needs
I don't believe in choosing a treatment model first and then trying to make the person fit it.
The approach should follow the person.
Depending on what you need and what we understand about your situation, our work may draw on several approaches.
EMDR
Eye Movement Desensitisation and Reprocessing (EMDR) can be used to help process traumatic or distressing experiences that continue to affect how you think, feel, respond or experience your body in the present.
Acceptance and Commitment Therapy
ACT focuses on developing psychological flexibility: becoming better able to make room for difficult internal experiences while moving towards the things that matter to you.
Neuroscience-informed coaching
Coaching can provide a more future-focused way of working when the emphasis is on understanding yourself, developing practical strategies, changing patterns or moving towards goals.
Psychoeducation
Sometimes understanding what is happening is itself an important intervention.
Learning about trauma, dissociation, the nervous system, neurodivergence or persistent physical symptoms can help reduce confusion and create more choices.
Psychological Formulation
A detailed formulation can bring together different aspects of your experience and provide a shared framework for deciding what might be helpful.
We don't have to decide everything at the beginning
You don't need to arrive knowing whether you need therapy, EMDR, coaching, ACT or something else.
You don't necessarily need to know what your diagnosis is.
And you don't need to have a perfectly formed explanation of what is happening.
We can start with what you do know.
What you're experiencing.
What you've tried.
What's helped.
What hasn't.
What you're worried about.
And what you want to be different.
From there, we can develop a clearer understanding of what might be useful.
Stabilise, understand, process, integrate and choose
For some people, particularly those affected by complex trauma or dissociation, meaningful change isn't a single event.
It can be a process.
Stabilise
Developing enough safety, understanding and practical resources to manage what is happening in the present.
Understand
Making sense of your experiences, symptoms, patterns and adaptations.
Process
Where appropriate, working with experiences that remain unresolved or continue to influence the present.
Integrate
Bringing new understanding, skills and ways of responding into everyday life.
Choose
Increasing the space between automatic patterns and your ability to decide what happens next.
The process won't necessarily follow these stages neatly, and not everyone needs every stage.
The important thing is that the work remains responsive to you.
The aim is greater choice
I don't see successful work as simply becoming someone who never experiences difficult emotions, physical symptoms, intrusive memories or unwanted thoughts.
That isn't a realistic definition of wellbeing.
A more useful question is:
How much choice do you have in how you respond to what happens inside and around you?
Can you recognise what is happening?
Can you understand it?
Can you respond rather than automatically react?
Can you make decisions based on what matters to you?
Can you build relationships, activities and a life that aren't organised entirely around avoiding distress?
Sometimes the goal is symptom reduction.
Sometimes it is understanding.
Sometimes it is learning to live differently alongside experiences that may not disappear completely.
Often it is a combination.
Ultimately, the aim is to create more possibilities.
More understanding.
More flexibility.
More agency.
And, increasingly, more choice in the life you are creating.
You don't have to fit yourself into a box
Your diagnosis may be important.
Your symptoms may be important.
Your history may be important.
But none of these things, individually, tells me everything I need to know about you.
My role is not to make you fit a particular model.
It is to work with you to understand the model that best makes sense of your experience, identify what can change, and find ways of moving towards the life you want to live.
You don't have to arrive with all the answers.
We can start with curiosity.