My approach to psychotherapy
- Siana McGarvey

- May 1
- 5 min read
Some examples of why people come to see me for psychotherapy include relationship or family difficulties, trauma (particularly related to childhood experiences), identity issues (often related to neurodivergence and / or gender and sexual identity), anxiety, feeling low or depressed, life changes and transitions, low self-worth.
From the outset it's important to say that I see you as a whole person doing the best you can to manage whatever life has dealt you. I don't split you into issues or problems to fix. I am fully aligned with the neurodiversity paradigm, firmly rejecting the medicalised view of autism and other neurodivergence as disordered. I welcome and prize members of the LGBTQIA+ community.
My main and foundational counselling training was at Durham University and was primarily person-centred. It was a full time Masters level course in 2000-2001 which incorporated personal therapy for us as participants, group process work, theory and skills training.
Person-centred counselling places a high value on the relationship between the therapist and the person seeking support, and in essence works on the basis that if the relationship provides certain core characteristics the conditions will be such that change is inevitable.
As the years have gone on I have become fascinated by the neuroscience which is providing a robust theory and research base for the phenomena which we see in successful therapeutic processes. I have completed 2 years of monthly training live online with Dr Bonnie Badenoch, a highly esteemed psychotherapist, teacher and author. Bonnie is gifted at translating neuroscientific concepts into accessible language. These courses were two of Bonnie's final programmes pre-retirement so it was a unique and rich opportunity to learn with one of the most respected and experienced practitioners of relational psychotherapy.
Below is a link to Bonnie's website:
The way a therapy session evolves is unique to everyone and impossible to predict in advance.The commitment is literally to show up and from there we work with whatever emerges. I get that this can be terrifying, especially at the beginning. I am not in the business of making things awkward or difficult I am open and friendly and I will support you to feel as comfortable as you can be. With me, there is definitely not a "blank screen" scenario which many can - rightfully - be concerned about. People often notice that I'm very "down to earth" in my approach and I don't hide my personality. I'm human.
Therapy works through the close attention we give to who you are at your core. We support the healing and integration of the aspects of you which have been harmed, denied and suppressed. This in turn helps parts of you which have been over-working to keep all this at bay to soften and change.
Therapy is actually not all doom and gloom, talking about your problems, crying and becoming more dysregulated. The opposite is more often the case - you will end up more balanced and "integrated" (less internal conflict), and when you go to the difficult places you will be able to go there at a different pace and in a different way.
This links into a key aspect of your experiencing which I encourage you to pay attention to in therapy with me - your nervous system. When we relate to each other, whether we think we are hiding it or not, our nervous systems are communicating below the level of conscious thought. No matter what words are actually spoken.
In therapy this is called working with neuroception as well as perception (conscious thoughts and feelings). It is our neuroception which directly affects our wellbeing, albeit below the level of awareness. This is why we can "cover up" only for so long.
My training on working with the nervous system was with Deb Dana on a year long programme live online in 2020-21. Your nervous system is your "bodymind"; it's effectively your command centre. This is why Deb would say something like "If the brain and nervous system got into a fight, the nervous system would win every time!" It doesn't matter how much you want to "do therapy", trust and enter into the process, it is your nervous system which will have the final say. Your brain might have ideas and you might know all the right things you need to do ... but when it comes down to it there is a much more primitive and nuanced internal system which has the last say. This is why some people get themselves through the door of a therapist's office, talk and talk and talk, and never actually "get around" to doing the work they need to do. Or they might appreciate having had the opportunity to talk but not actually experience their relationships or their quality of life as having changed in a significant way.
This is Deb's website for anyone interested in learning more:
For Curious People | Rhythm of Regulation
In psychotherapy we have the opportunity to attend to the relationship between our nervous systems, mine and yours. This goes way beyond words and analysis. There is no right or wrong and no quick fixes, but if we can be curious and open to what is there on that level we just might be able to welcome it, get to know where it is coming from, offer some connection and support long term habitual patterns to come unstuck.
Dr Stephen Porges, a highly respected psychologist and neuroscientist, writes about co-regulation and connection as a "biological imperative". By this he means that we aren't meant to "self regulate" or go it alone. These are adaptive responses to survive in unfriendly or unsafe environments and relationships. Nevertheless, when we come into an experience of genuine safety and welcome with another we are "wired" to seek connection, however momentary that may be in the beginning. The neuroplasticity of our brains throughout the life span means that this is possible no matter what age we are. Yes, of course, it would ideally happen when we are little but the positive news emerging from the neuroscience over the past 20 years is that early childhood experiences and traumas are not a lifelong sentence as was previously believed.
In summary, a psychotherapeutic process can provide a relationship and environment conducive to deep healing and reconsolidation of neural pathways.
Trauma and the Nervous System: A Polyvagal Perspective - YouTube
Stephen Porges Safety IS the Treatment - YouTube
Sometimes people enter psychotherapy when they've hit rock bottom and for others it can feel like they go "down" before things begin to improve. When you are not alone, though, you are unlikely to become overwhelmed and frozen.
Instead, you have the possibility to tread out new pathways and possibilities in real time, with the consistent support and attunement a therapist can offer.
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