Relational psychotherapy pays close attention to what happens between us, as well as to what is being talked about. The therapeutic relationship is not separate from the work; it is one of the ways change becomes possible.

Its roots are in psychoanalytic thinking, particularly traditions that emphasise the importance of early relationships, attachment, unconscious patterns, and the way our sense of self develops in connection with others. Rather than seeing the therapist as a detached observer, relational psychotherapy understands therapy as a living relationship in which old expectations, protections, longings, and fears may begin to show themselves.

This includes noticing patterns that may emerge in contact — for example around trust, closeness, distance, misunderstanding, shame, disappointment, or the expectation of how another person may respond. These patterns are not treated as problems to judge, but as important expressions of how you have learned to relate, protect yourself, and make sense of experience.

Relational psychotherapy also pays attention to what may be communicated indirectly: through pauses, emotional shifts, bodily responses, uncertainty, compliance, withdrawal, humour, or the wish to protect the other person. Often, these subtle moments can reveal something important about how earlier relational experiences continue to shape present-day life.

Worked with carefully, the therapeutic relationship can become a place where old expectations are understood more fully, and where new experiences of safety, repair, and connection may gradually become possible. The aim is not simply to talk about relationship patterns, but to understand and experience them in a different way, at a pace that feels sufficiently safe and respectful.

Transactional Analysis offers a clear and psychologically rich way of understanding how early experience can shape present-day patterns of feeling, thinking, relating, and coping.

One of its central ideas is that we move between different ego states — often described as Parent, Adult, and Child. These are not fixed “parts”, but recognisable patterns of experience: for example, a critical inner voice, a compliant or adapted response, a vulnerable younger feeling, or a more reflective and grounded capacity to think, feel, and choose.

TA also pays attention to transactions: the patterns that happen between people. These can help make sense of why certain interactions repeatedly lead to anxiety, conflict, withdrawal, over-responsibility, people-pleasing, or feeling misunderstood.

Another important area of TA is script: the unconscious expectations, beliefs, and survival decisions formed earlier in life that can continue to influence adult choices and relationships. These may include familiar pressures such as needing to be strong, pleasing others, trying harder, hurrying up, or getting things right.

In therapy, TA can help you recognise these patterns with more clarity and compassion. The aim is not simply insight, but greater autonomy: more capacity for awareness, choice, spontaneity, and genuine contact with yourself and others.

Integrated with the other approaches I use, Transactional Analysis supports a practical and depth-oriented way of working with trauma, attachment, self-criticism, relational patterns, and the ways people learned to adapt in order to manage or stay safe.

Relational Transactional Analysis develops these ideas further by bringing TA into dialogue with the relational psychoanalytic paradigm. It keeps TA’s attention to ego states, transactions, script, and autonomy, while placing greater emphasis on the therapeutic relationship itself — including what happens between therapist and client in the room, how patterns are co-created, and how new relational experience can support psychological change.

Read more:

Transactional Analysis ›

Relational TA ›

Parts-informed work can be helpful when someone feels caught between different inner responses — one part wanting change, while another feels anxious, critical, protective, overwhelmed, or shut down.

This way of working is closely related to Internal Family Systems (IFS), which understands the mind as made up of different inner parts, each with its own feelings, fears, protective strategies, and intentions. Some parts may try to keep things under control; others may carry vulnerability, shame, anger, grief, or unmet needs. Parts work offers a way of listening to these inner responses without immediately trying to override them.

Rather than treating these responses as irrational or trying to get rid of them, we approach them as meaningful adaptations, often shaped by life experience, stress, or trauma. A self-critical part, for example, may have developed as a way of preventing rejection, failure, or emotional exposure. A shut-down part may be trying to protect you from overwhelm. A driven or coping part may have helped you keep going when there was little room to stop.

This can help reduce inner conflict, deepen self-understanding, and make it easier to respond with more clarity and compassion. Over time, parts that once felt extreme, disruptive, or shameful may become more understandable, and there may be more room for choice rather than automatic reaction.

In my practice, parts-informed work is integrated with relational psychotherapy, Transactional Analysis, Sensorimotor Psychotherapy, Deep Brain Reorienting (DBR), and attention to the nervous system. The aim is not only greater understanding, but a deeper sense of safety, steadiness, and connection — both within yourself and in relationship with others.

EMDR-informed work draws on selected elements of EMDR — Eye Movement Desensitisation and Reprocessing — a trauma-focused therapy developed to support the processing of experiences that have remained insufficiently integrated.

When something overwhelming happens, the brain and nervous system may not process the experience in the usual way. Memories can remain highly charged, fragmented, or easily reactivated by present-day situations. This may show up as intrusive images, body sensations, emotional flooding, avoidance, shame, anxiety, or a sense that something from the past is happening again in the present.

EMDR uses bilateral stimulation — such as eye movements, alternating sounds, or taps — while aspects of an experience are briefly held in mind. This can help the brain reprocess distressing material so that memories become less emotionally charged and more clearly located in the past.

In my practice, I may draw on selected EMDR-informed elements within a relational, trauma-informed, and nervous-system-aware approach. This may include careful preparation, resourcing, attention to present-day triggers, and gentle ways of working with memory, imagery, body sensation, and emotional activation.

I do not use EMDR as a separate stand-alone track in my practice. In some cases — particularly where trauma adaptations are more deeply held, developmental, relational, or linked with dissociation and shutdown — EMDR can risk moving too quickly for the system, even when used carefully. For some people, the pace or intensity may be less well tolerated.

For that reason, Deep Brain Reorienting (DBR) remains my primary modality for deeper trauma processing. DBR can offer a slower and more finely tracked way of working with shock, orienting responses, and early threat activation before the system moves into fuller emotional processing.

Where appropriate, EMDR-informed work may still form part of an integrated therapeutic process, alongside relational psychotherapy, Sensorimotor Psychotherapy, DBR, parts-informed work, and attention to the nervous system. The aim is not simply to process memories quickly, but to support change in a way that is sufficiently paced, grounded, and integrated.

Sensorimotor Psychotherapy is a trauma- and attachment-informed approach that includes the body as an important source of information — not to over-focus on sensation, but to listen carefully to what the nervous system may already be communicating.

Many people can understand their story clearly, yet still feel overtaken by anxiety, shutdown, numbness, collapse, tension, or sudden surges of emotion. This is because trauma and attachment patterns are not held only as thoughts or memories; they can also be held in posture, movement, breathing, muscle tension, impulses, and patterns of protection.

Sensorimotor work helps us slow things down and notice what happens in the body with care. This might include tracking subtle shifts in activation, noticing impulses to move away, freeze, brace, please, collapse, push through, or protect, and exploring how these responses once made sense in the context of your experience.

The aim is not to analyse the body from the outside, or to push into overwhelming sensation. Instead, the work supports a more respectful relationship with the body, so that patterns can become more understandable and more workable. Over time, this can create more room for choice, regulation, and embodied safety.

This may include building resources for steadiness, working gently with activation and boundaries, exploring protective responses, and supporting integration across body, emotion, and thought. As throughout my work, pacing matters: stability comes before intensity, and the body is approached as something to collaborate with rather than overcome.

Read more:

What is Sensorimotor Psychotherapy? ›

Deep Brain Reorienting (DBR) is one of the key trauma-processing approaches I use in my practice. It is a depth-oriented therapy that works with the body’s early threat, orienting, and attachment shock responses — the fast, involuntary reactions that can become set in place before words, clear meaning, or conscious understanding are available.

When something feels threatening or overwhelming, the nervous system often responds before we have time to think. The body may orient, brace, freeze, collapse, reach, pull away, or prepare for danger. In trauma, these early responses can remain unresolved, so that present-day situations may trigger reactions that feel disproportionate, confusing, or difficult to control.

DBR helps us work carefully with these very early layers of response. Rather than relying only on talking through what happened, DBR tracks what the nervous system is doing in the present moment — often beginning with subtle changes around orienting, tension, shock, or bodily activation. This can be especially helpful when someone understands their history well, but their body still reacts as if something is not safe.

A central part of DBR is its attention to the sequence of activation. Before strong emotion, image, or story emerges, there is often a more immediate bodily response: a moment of shock, alarm, or orienting towards threat. By working at this earlier level, DBR may allow traumatic material to be processed without needing to push quickly into intense emotional re-experiencing.

This makes pacing especially important. DBR is not about forcing catharsis, reliving trauma, or moving quickly into overwhelming material. We work slowly, stay within tolerance, and prioritise stability, safety, and integration. The aim is for processing to happen in a way the nervous system can manage, rather than creating intensity without lasting change.

DBR can be particularly relevant where trauma is held not only as a memory, but as a pattern of bodily alarm, shutdown, vigilance, shame, or relational threat. This may include shock trauma, attachment trauma, developmental trauma, and experiences where something in the body still responds as if danger is present, even when the adult mind knows the situation is different now.

As with all my work, DBR is held within a relational and trauma-informed therapeutic frame. The therapeutic relationship remains central: it helps create the steadiness, attunement, and safety needed for this depth of process. DBR is not used as a technique in isolation, but as part of a carefully paced therapeutic process shaped around your history, capacity, and readiness.

Current evidence

DBR is an emerging trauma-processing approach that directs attention towards early bodily responses associated with threat, shock and emotion. Early research includes a small randomised controlled trial involving adults with PTSD, comparing eight online DBR sessions with a wait-list condition. The findings were promising, but the research evidence remains limited and is still developing.

Alongside this emerging research, practitioners within the growing international DBR community report encouraging clinical experience using the approach with developmental and attachment trauma, complex trauma—including presentations described as complex PTSD—and dissociative difficulties. These practitioner observations are clinically relevant, but they are not yet equivalent to controlled evidence of effectiveness for these populations.

I use DBR within a wider relational and trauma-informed formulation and review its fit, pacing and the person’s response collaboratively.

Read more:

The Hypothetical Basis of DBR ›

DBR articles from my blog ›

A jargon-free description of DBR and the current evidence › ‍

Randomised controlled trial of Deep Brain Reorienting ›‍

ILF neurofeedback is a gentle, non-invasive way of supporting the brain’s capacity for self-regulation through real-time feedback. Many people come to it when they feel caught in patterns of over-activation — such as anxiety, hypervigilance, emotional reactivity, poor sleep, or a racing mind — or under-activation, such as shutdown, fatigue, fog, or low motivation, even when they understand what is happening psychologically.

In infra-low frequency (ILF) neurofeedback, the aim is not to force change, override symptoms, or train the brain through effort. Instead, the brain receives information about its own activity and can gradually use that feedback to organise itself differently. Over time, people may notice shifts in sleep, steadiness, concentration, reactivity, resilience, and their general ability to settle or recover after stress.

A central focus of ILF work is regulation and stability. This can be especially relevant when the nervous system seems to move too easily into threat, overwhelm, shutdown, vigilance, or exhaustion. In this sense, ILF neurofeedback can support the foundations that make psychotherapy more possible: enough steadiness, capacity, and resilience for deeper emotional and relational work to be tolerated.

I also integrate ILF with frequency-based neurofeedback training where clinically appropriate. Frequency-based training can allow more targeted work with particular patterns of arousal, attention, activation, or settling. Used carefully, it can complement ILF by giving another way of supporting nervous-system regulation and flexibility.

In my practice, neurofeedback is not offered as an isolated technical service without a wider clinical formulation. Where appropriate, I may integrate ILF neurofeedback and frequency-based training within psychotherapy with me, or offer it alongside psychotherapy, psychiatric care or other relevant clinical care where roles, communication and responsibility are sufficiently clear. This allows responses to training to be understood in context, paced carefully, and considered in relation to the person’s wider therapeutic or clinical work.

We go slowly, track responses carefully, and adjust the training as needed. The aim is not simply to produce short-term symptom change, but to support a more stable and organised nervous system so that life — and therapy — can feel more manageable, grounded, and integrated.

Read more:

Neurofeedback ›‍ ‍

Neurofeedback research ›

The approaches listed above do not simply sit alongside one another as a collection of techniques. Each offers a different perspective and point of access to the client’s experience, and they may prepare for, support, deepen or integrate different parts of the therapeutic process.

The work remains relationally grounded throughout. The therapeutic relationship provides the continuing context in which experience can be approached, understood and integrated. Within that relationship, different approaches allow us to attend to cognitive, emotional, relational, embodied, autonomic and trauma-related processes without assuming that any one model can adequately account for the whole person.

Transactional Analysis and parts-informed work can help differentiate internal responses, understand earlier adaptations and strengthen the continuing function of the Integrating Adult. My knowledge of Internal Family Systems also enriches the way I approach parts work, particularly through its attention to protective intentions and internal conflict, although I do not practise IFS as a separate primary modality.

Sensorimotor Psychotherapy brings attention to bodily organisation, posture, movement, procedural patterns and defensive responses. Deep Brain Reorienting provides a structured way of approaching trauma-related experience that may remain difficult to reach through insight or narrative work alone. Finding Solid Ground practices and ILF neurofeedback may help develop the stability and regulatory capacity needed to participate in deeper therapeutic work.

EMDR-informed knowledge also contributes to how I understand traumatic memory, present-day triggers, associative processing, dual attention, pacing and the consolidation of change. Although I have completed EMDR training, I do not practise EMDR as a primary modality or routinely offer the full standard protocol.

These approaches do not correspond to completely separate levels that can be treated independently. Changes in regulation may make relational or trauma-processing work more possible. Trauma processing may bring forward material that needs further embodied, relational or parts-based integration. Cognitive understanding may help a client make sense of changes that were first experienced through the body. Each approach can therefore add value to the others while retaining its own distinct contribution.

My developing knowledge of psychedelics and psychedelic integration adds a further and materially different perspective. Psychedelics may alter consciousness, psychological openness and access to emotional, embodied and symbolic material through processes that differ from those involved in DBR, Sensorimotor Psychotherapy or relational work. Understanding these differences informs how I think about preparation, destabilisation, competing therapeutic processes and the integration of powerful experiences. This should not be understood as an offer of psychedelic-assisted therapy or as advice about obtaining or using psychedelic substances.

The aim of integration is not to make every modality say the same thing. It is to understand what each can and cannot contribute, how their effects may interact, and how they can be brought together coherently, carefully and responsibly around the needs, capacities and developing formulation of each client.