What I Work With
When your experience doesn't fit neatly into a box
People rarely arrive as a diagnosis.
You arrive with a history, a body, a nervous system, relationships, experiences, strengths, difficulties and ways of coping that have developed over time.
Sometimes a diagnosis provides a helpful framework for understanding some of this. Sometimes it doesn't quite explain enough. You may have several diagnoses, conflicting explanations, or no diagnosis at all.
You may have spent years trying to understand why you feel, think, behave or respond in particular ways.
My work is particularly focused on experiences where things are complex, interconnected or difficult to explain through a single lens.
This includes complex trauma, dissociation, persistent physical symptoms, functional neurological symptoms, ADHD and the ways these experiences can overlap.
The list below isn't intended to define you or determine what approach you need. It provides an indication of the kinds of difficulties and experiences I can work with.
Complex trauma
Trauma doesn't always come from one clearly identifiable event.
For some people, difficulties develop through repeated experiences of fear, neglect, instability, abuse, loss, invalidation or relationship difficulties, particularly during childhood or other important periods of development.
Complex trauma can affect much more than memories of what happened.
It can influence:
- how safe you feel with other people
- how you understand yourself
- emotional regulation
- relationships and attachment
- boundaries
- self-worth
- attention and concentration
- bodily responses
- patterns of avoidance
- dissociation
- the way you respond to perceived threat
Sometimes these responses can seem confusing or disproportionate in the present.
Understanding them as adaptations can provide a different starting point for change.
I work with complex and developmental trauma, including experiences that continue to affect the present long after the original circumstances have changed.
PTSD and trauma-related difficulties
Traumatic experiences can remain active long after an event has ended.
You may experience intrusive memories, nightmares, avoidance, hypervigilance, changes in mood or beliefs, physiological responses, or a persistent sense that you are not quite safe.
For some people, trauma is very clearly identifiable.
For others, it can take time to understand why particular situations, relationships, sensations or emotions trigger such strong responses.
Where appropriate, trauma-focused approaches such as EMDR may form part of the work.
The aim isn't simply to make you forget what happened.
It is to help your past become less controlling of your present.
Dissociation
Dissociation can take many forms.
You might experience:
- feeling detached from yourself
- feeling unreal or disconnected from your surroundings
- gaps or disruption in memory
- feeling as though you are observing yourself from the outside
- different or conflicting self-states
- losing track of time
- feeling emotionally numb
- functioning automatically without feeling fully present
For some people, dissociation develops as a way of managing experiences that were too overwhelming to process at the time.
It can become an automatic response, particularly when the nervous system detects threat.
I work with dissociative experiences and dissociative disorders within their wider psychological and developmental context.
This work requires care, particularly when dissociation is longstanding or complex.
The aim is not to force you to confront experiences before you have sufficient stability and resources to do so.
Persistent Physical Symptoms
Persistent physical symptoms are real, whether or not conventional medical investigations identify a structural cause.
Some people live with pain, fatigue, dizziness, weakness, sensory changes, gastrointestinal symptoms, headaches or other persistent symptoms that have become difficult to explain or manage.
You may have been through repeated investigations and appointments without finding an explanation that adequately accounts for your experience.
This can be frustrating and, sometimes, deeply invalidating.
My approach is not to assume that symptoms are "all in your head".
Instead, I consider the complex interaction between the brain, nervous system, body, psychological experience, learning, environment and previous experiences.
Where appropriate, this work takes place alongside medical assessment and treatment rather than replacing it.
Functional neurological symptoms and FND
Functional neurological symptoms can include experiences such as:
- functional movement symptoms
- functional seizures
- weakness
- altered sensation
- tremor
- gait difficulties
- episodes of altered awareness
- other neurological symptoms that do not correspond straightforwardly with structural neurological disease
These symptoms are genuine and can be profoundly disruptive.
Understanding how the nervous system is functioning can sometimes provide a different way of making sense of what is happening.
I can work with the psychological and behavioural aspects of FND and related functional symptoms, including the potential contribution of trauma, stress, learned responses and nervous system threat responses.
This does not mean assuming that trauma or stress is necessarily the cause.
Each person's experience needs to be understood individually.
ADHD, Neurodivergence and Trauma
The overlap between Neurodivergence and trauma can be particularly complex.
Some experiences can look similar on the surface while having very different origins.
Difficulties with concentration, emotional regulation, impulsivity, sleep, relationships, avoidance or feeling overwhelmed may be influenced by ADHD, trauma, chronic stress, dissociation or a combination of factors.
Understanding those differences can be useful because the most helpful response may depend on what is actually maintaining the difficulty.
The question isn't simply:
"Which label explains me?"
It is:
"What is happening for me, and what would help?"
Emotional regulation and overwhelming emotions
Some people experience emotions with extraordinary intensity.
You may find that once an emotion starts, it becomes difficult to step back from it. You might become overwhelmed by anger, fear, shame, sadness or anxiety, or experience rapid changes in emotional state.
Others may have learned to suppress emotions so effectively that they struggle to recognise what they are feeling at all.
These patterns can develop for many reasons, including trauma, neurodivergence, relationships, learning and repeated experiences of having emotions dismissed or punished.
We can explore both what happens emotionally and what happens around the emotion, including the thoughts, bodily sensations, behaviours and interpersonal patterns that accompany it.
When you've been misunderstood
Some people come to me after years of trying to find an explanation.
You may have been given several diagnoses.
You may have been given none.
You may have been told that your symptoms are psychological without anyone adequately explaining what that means.
You may have found that one professional sees trauma, another sees ADHD, another sees a physical disorder, while none of the explanations quite account for the whole picture.
Or you may simply know that something isn't right, but haven't found a framework that makes sense of your experience.
This is where taking time to develop a careful formulation can be particularly valuable.
You don't necessarily need another label. You may need a better understanding of the pattern.
The mind, brain and body
I am particularly interested in the relationships between psychological experience, the brain, nervous system and body.
This can be relevant across many of the difficulties described above.
Stress can affect physiological processes.
Learning can shape automatic responses.
Trauma can influence threat detection and patterns of responding.
Attention can alter what we notice.
Memory can influence how present experiences are interpreted.
The nervous system can respond to perceived threat before we have consciously identified what is happening.
None of this means that psychological explanations make physical experiences less real.
It means that human experience is interconnected.
Understanding those connections can sometimes open up possibilities that weren't apparent when mind and body were considered separately.
Sometimes there isn't one answer
One of the most important principles in my work is that complex experiences don't always have simple explanations.
You can have ADHD and trauma.
You can have a physical condition and psychological difficulties.
You can experience dissociation without having a dissociative disorder.
You can have persistent physical symptoms alongside structural medical conditions.
You can have more than one thing happening at the same time.
The presence of one explanation doesn't automatically exclude another.
Rather than trying to identify a single cause at all costs, I am interested in developing an understanding that is sufficiently nuanced to be useful.
What happens when we understand the pattern?
Understanding isn't the end of the process.
It gives us somewhere to start.
Once we have a clearer sense of what may be happening, we can consider what might help.
Depending on your circumstances, this might involve:
Therapy
Exploring and changing longstanding psychological, emotional or relational difficulties.
EMDR
Working with traumatic or distressing experiences that continue to affect the present.
ACT
Developing psychological flexibility and moving towards the things that matter to you.
Neuroscience-informed coaching
Understanding patterns of behaviour, attention, emotion and learning and translating that understanding into practical change.
Psychoeducation and formulation
Developing a clearer understanding of why particular patterns may have developed and what maintains them.
The approach follows the person.
It isn't the other way around.
You don't have to know which category you belong to
You don't need to diagnose yourself before getting in touch.
You don't need to decide whether what you're experiencing is trauma, ADHD, dissociation, FND or something else.
And you don't need to know whether you need therapy or coaching.
If your experience is complicated, confusing or difficult to put into words, that is enough of a starting point.
We can begin with what you know.
What you're experiencing.
What you've tried.
What makes things better or worse.
What you understand already.
And what you would like to be different.
From there, we can work towards a clearer understanding and identify what might help you move forward.