Is Botox a Replacement for Psychotherapy and Counselling?

Does Freezing our Expressions Mean an End to Psychotherapy and Counselling Exploration?

In March 11th edition of The Guardian Mental Health, Jay Watts wrote the following:

“The publication of a new book, The Face of Emotion: How Botox Affects Our Moods and Relationships, by dermatologist and MD Eric Finzi, together with several recent academic studies on the effects of Botox on mood, have generated a spate of phone calls this week from beauty editors to psychologists like me. Is it true, we are asked, that injecting Botox can actually change the way we feel, transforming not just our body image but also the very emotions we experience within ourselves?

The new studies revive the old “motion is emotion” theory to suggest if a woman cannot make certain expressions – such as frowning – she is less likely to feel discontent or depressed. Her brain, the argument goes, will not read muscular movement associated with anger as present, so she will not feel angry. Aesthetic procedures that freeze our expressions can thus affect our emotional lives. Should the depressed be reaching for the Botox? Can facial filler really make us happier?

When parents threaten their grimacing children “if the wind changes, your face will stay like that forever”, they offer it as a threat. Yet the aesthetics industry would see “staying like that forever” as a good thing, providing the face stuck to is one that does not show any sign of ageing, distress or – in this new wave of propaganda – anger.

Most of us think that our facial expressions reflect our feelings, experiences, age, and perhaps when we last went to buy makeup. We also tend to think people’s faces express their more general take on the world. The comedian Jack Dee, for example, has talked about how his “hangdog expression” is seen by most as saying something about his outlook. “The motion is emotion” theory argues the opposite. It is our facial expression that dictates how we actually feel, rather than revealing an underlying state. If a face is frowning – an expression often associated with anger – we may recognise this association and begin to actually feel angry inside. Others may then react to us as if we were angry, producing a reinforcement cycle where people frown back at us and we are caught in a perpetual spiral of rage.

This theory goes back to the early 20th century, when psychologist and philosopher William James argued that “a man does not cry because he is sad, he is sad because he cries”. Emotion here is seen as a reaction in the body – a set of muscular and chemical events. Recent studies have revived these ideas, claiming that freezing emotional expression through using Botox has a positive effect on depression. Journalists are being briefed that Botox may even prove a universal panacea for depression as a facial motion previously associated with anger is no longer possible, which will make us all happier. Should we throw out the SSRIs and rush to Harley Street?

Maybe not yet. All this is based on a very simplistic understanding of emotion. Within the laboratory, a face with a frown may be read as quickly as an angry one, yet our real-world experiences of each other are nearly always in interaction. Our brains pick up cues of how someone else might be thinking and feeling on a second-by-second basis. We do not see a couple of frown lines, a couple of furrows and process “sad face”, “happy face” but rather pick up cues from a mixture of facial expression, gait, voice cadence, posture, context, eye movement, as well as the fantasies and projections we bring with us to every social exchange.

The new “Botox theory” ignores this complexity, seeing emotion as little more than the awareness of a set of physical reactions. It also neglects something crucial described by writers for centuries: the horror of the uncanny. We experience this when we see an actress or woman of a certain age and feel that something is wrong. Perhaps she has the plumped out cheeks of early youth, the ironed-out forehead of Botox, yet also middle-age crow’s feet. If the work is good, we may not know explicitly what is wrong, but we sense instantly that something is awry. There is a gap between the mask we see and what we expect to be in its place.

This will have an immediate effect on how we then relate to that person. Someone may be telling us the saddest story, but if the facial cues are dissonant, we won’t be quite present either. Colleagues tell me of their feeling “something is really wrong” with new patients because they find it difficult to attune to what is going on for them, only later to find out the patient has regular Botox. And this, of course, generates its own paranoia: “Does he know?”, “Is she treating me differently?”, “Can people tell?”.

The misappropriation of the “motion is emotion” theory by a plastic surgery industry that wants to get rid of our angry faces to make us happier forecloses the real issue. People can tell when something is not right with facial expression, and that will leave women feeling more alienated, more alone, more paranoid than ever. Botox might block us from making the expressions we used to make when angry, but it can never get rid of our internal worlds. If there is anger there, why not think about it rather than try to excise it? The Botox route, fuelled by questionable “science”, denies the legitimacy of a woman’s anger, as if de-ageing and depoliticising had become one and the same thing.”

Just because we do not show an expression does not mean that the cause of depressed or upsetting feelings has gone away. Sometimes help to discover and understand these causes is needed and professional psychotherapy support is required.

The three psychotherapists at The cavendish Psychotherapy Practice at 121 Harley Street, London, are professional, experienced, confidential and ethical and can work with you to uncover the roots of your difficulties.

Men are Less likely to Seek Psychotherapy or Counselling than Women

Men are More Reluctant to Seek Psychotherapy and Counselling help than Women

In a recent article published in the BACP’s monthly magazine, ‘Therapy today’, Colin Penning writes, “Many people think men’s emotional literacy and ability to articulate their feelings is less than that of women. The question then is, do these assumptions about men reflect a stereotype or a reality? This was the question that Relate and the Men’s Health Forum set out to explore in their new report Try to See it My Way.

We know that men are more reluctant than women to seek support and advice when relationships run into difficulties. Far fewer men use telephone advice and helpline services. We also know that men are less likely to access counselling services generally. Men make up just 36 per cent of referrals to the Improving Access to Psychological Therapies (IAPT) programme. They are also under-represented in relationship support services: just 44 per cent of Relate’s clients are men.

So why can’t (or won’t) men seek help for emotional problems? The first and most obvious answer is that men are socialised not to admit to vulnerability, which is a prerequisite of securing help. The second is that maybe we aren’t offering the kind of support that men can relate to and that they find helpful.

The report suggests work is a key factor. Men’s tendency to work longer hours can cause relationship problems and conflicts around the life–work balance; financial difficulties can increase pressure on the man, who is often still the primary breadwinner in the family.

One of the key findings of the report is that men and women have very different approaches to communication. Insights generated by two focus groups of Relate counsellors found that men have a tendency to want to ‘solve problems’ while women want to discuss change and understand why things have happened. So men are coming to counselling with unrealistic expectations.

But the Relate counsellors told us that men may have become more open to the idea of relationship counselling in recent years. And they told us there may be things we can do to reach out to and engage men in taking better care of their own emotional health.

Our report makes a series of recommendations. Some are to national Government around raising men’s awareness of the importance of emotional health and making personal, social and health education a statutory requirement in schools. ”

Admitting to finding things difficult and seeking help is not a weakness. The therapists at The Cavendish Psychotherapy Practice have many years experience working through issues presented by male patients in order to discover what lies at the root of their difficulties.

The Cavendish Psychotherapy Practice is found at 121 Harley Street, London.

Psychotherapy Support for Actors

Research Shows Psychological Vulnerability in Actors

A recent study by California State University looked at the psychology of the sort of people who choose to become actors. The results imply that these people tend to be imaginative but also emotionally vulnerable.

Paula Thomson and S. Victoria Jaque wrote in the Psychology of Aesthetics, Creativity and the Arts journal that “Our study adds to the body of research that suggests there is a psychological cost for participants engaged in the creative arts”.

Their study looked at 41 professional actors living in Cape Town. Toronto and Los Angeles and compared them with people from other artistic groups such as athletes and art lovers.

What they discovered was that, “Even though there was no difference between the two groups for past traumatic events, more actors were unable to maintain narrative coherence when discussing memories of past trauma and loss.” The actors struggled when attempting to discuss past traumas which the researchers felt suggested that they find it harder to resolve these traumas.

The researchers illustrated how the actors had an increased ability to “remain engaged, regulated and coherent during the interview process”, however, they were also more likely to show signs of confusion, prolonged silence or “unsuccessful failures to deny a traumatic or loss event”. Thomson and Jaque argue that this suggests “a greater vulnerability for psychological distress”.

Thomson and Jaque give a note of caution to those thinking of an acting career in therapeutic terms: “Actors may have enhanced their imagination through the practice of acting or they may have entered a career that supports their heightened predisposition for fantasy.”

For those who do choose to become actors, there is psychological support available in the form of talking therapies such as psychotherapy and counselling. This can help develop an understanding of past traumas and resolve feelings surrounding them.

The psychotherapists at The Cavendish Psychotherapy Practice on London’s Harley Street, work with people of all backgrounds, including members of the performing arts who struggle with emotional and psychological problems.

Internet Porn Addiction: Can Psychotherapy Help?

Psychotherapists Might Consider 10 Hours p.w. Too Much

Internet Porn Addiction: A Quarter of Men Surveyed Worried About the Amount of Porn they are watching.

A recent survey carried out by the Tavistock and Portman clinic, revealed that 25% of men believe they are viewing too much porn. The ease at which porn can be viewed at no cost, may be the key to the rise in the amount being watched.  4% of men surveyed said they were watching more than 10 hours of porn per week – a rate that therapists at The Cavendish Psychotherapy Practice in London would consider problematic.

“Someone watching ten hours of porn per week could be heading towards compulsive and addictive behaviour” says Rebecca Barrie, psychotherapist at the Cavendish Psychotherapy Practice.   “It’s likely that someone who’s watching that amount of porn could be struggling in other areas of their lives. It would almost certainly be affecting their sexual relationships – influencing their sexual behaviour, it might also be causing concern in other ares of their lives – work might begin to suffer.

When use of porn is compulsive and the individual continues to engage in it despite negative consequecies in realtionships or other areas of life, addiction may be setting in.

It might be important for those who feel their casual use of porn is escalating to reassess their use,  and ask themselves why they are needing to escape into the fantasy worlds that porn sites provide.

Counselling and psychotherapy can provide an excellent support for anyone who is concerned about their use of porn.  The Cavendish Psychotherapy Practice in London offers descrete, confidential and professional psychotherapy to those looking to explore their compulsions or addictions.

The Cavendish Psychotherapy Practice is based in Harley Street, Central London.

Psychotherapy for Psychosexual Difficulties

Psychotherapy can help with Psychosexual Difficulties

At The Cavendish Psychotherapy Practice, therapists are experienced in working with those struggling with psychosexual issues. Psychosexual therapy looks at how emotional factors, not always apparent at a conscious level, can influence sexual performance and enjoyment as well as our sexual choices.

Psychosexual counselling or therapy helps address the underlying psychological or emotional causes of sexual difficulties. In talking to a therapist in a confidential environment, issues that may seem very difficult to talk about with lovers or friends, can be shared, explored and often resolved. Issues that the Cavendish Psychotherapists are experienced in working with include; lack of desire, fear of sexual contact, fear of sexual organs, body dysmorphia, sexual compulsion, sexual orientation and gender confusion.

The Cavendish Psychotherapy Practice is in Harley Street, Central London.