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Get inside the mind of a therapist.

How do you review something so layered, so insightful, so expertly created? 

These are the questions I’m asking myself as I sit down to write this review of “Maybe you should talk to someone” by American psychotherapist Lori Gottlieb.

In this instant New York Times bestseller, Gottlieb tells her story of being a therapist, whilst also attending therapy as a client herself, the very same position I was in when my good friend gifted me this book. 

Gottlieb begins by posing the question, “how do we change?” and through the pages of her book she responds, “in relation to others”. The therapeutic process is brought to life by Gottlieb sharing her clients’ stories, her own perspective of sessions and clients, and how she finds relating to her own therapist, Wendell. The latter of which she captures brilliantly in her line, “I both loved and hated Wendell for saying that”. 

The strength and depth of the therapeutic relationship is the basis for effective work. But just like any other relationship, it can be complicated. It’s the process of turning up, sitting in discomfort, and doing the work from both client and therapist that creates safety for exploring and creating change. 

This book is an expertly crafted interweaving of stories that exemplify the therapeutic arc taking us from what’s bringing clients to therapy now, laying it all out, editing the narrative, moving towards meaningful change, and coming to an end.

Gottlieb introduces us to four of her clients:

  • A twenty-something who is into bad guys and booze
  • A thirty-year-old newlywed with a terminal illness
  • A forty’s TV producer who calls everyone else an idiot
  • A 69-year-old contemplating suicide if things don’t get better

Through these tales we sit in ambivalence with the twenty’s client, face death with the thirty’s, learn about defence mechanisms with the forty’s, and seek forgiveness with the almost-septuagenarian. The craftsmanship of the writing absorbs you in each client making it easy to follow each client’s journey. 

Just like therapy, as the stories unfold and we delve into the depths of learning with Gottlieb and her clients, there’s a somewhat sudden, yet also subtle, shift as the pace picks up as they all move through their change process, pictured below:

Stages of Change, James Prochaska, 1980s

Gottlieb describes this change process as happening “gradually and then all at once”. 

This book is one to be highlighted and scribbled on as Gottlieb brings an abundance of knowledge to every page. 

You’ll find out about:

  • Erikson’s psychosocial changes
  • Four ultimate concerns
  • Misery-seduction dynamic
  • Privacy vs. secrecy
  • Projection and projective identification
  • Reacting vs. responding
  • Ultracrepidarianism
  • Unconditional positive regard
  • And much, much more!

It’s not just the psychological context but also Gottlieb’s graceful articulation of tender moments of therapy that you’ll want to underline. A standout line for me was: “I watch her hear what she already knows” which for me called to mind so many of my wonderful clients, particular moments where we’ve sat in the reality of it all, where I’ve seen emotions appear before my eyes, where I’ve felt a physiological shift in my body and observed the shift in them as we arrive at and embody realisations. 

Therapists are somewhat mysterious as our work is bound with confidentiality, meaning that people often struggle to grasp the nature of our day-to-day as we can’t elaborate or exemplify what we do. By bringing the four clients plus herself as a fifth client, Gottlieb provides a real insight into how clients present and how therapists work in session, and how therapists are in Gottlieb’s words, “a card-carrying member of the human race” which is not a flaw, it’s our biggest credential.

Gottlieb captures the sense of mystery when she addresses the question that we therapists often get asked “what kind of people do you see in your practice”, to which she responds, “just like any of us, which is to say, just like whoever is asking”. 

You don’t need to be in crisis, you don’t need to have a diagnosis, therapy is for any of us.  

Throughout writing this review, I caught myself being tempted to refer to the author as “Lori”. This speaks to the familiarity she creates through her writing. It feels deeply personal and vulnerable whilst also feeling very considered and expertly crafted. I also struggled to write this review because I didn’t want to say too much that would spoil the story unfolding for you!

I highly recommend this book – whether you’re interested in going to therapy, have already been, are a therapist yourself, you want to learn more about humans, or you just want a damn good read.

Expertly written, this book is an absolute gem that I’m sure I’ll be rereading for years to come. 

* Bonus recommendation: If you read the book and enjoy it, I’d also recommend watching Couples Therapy on BBC iPlayer which is a similar behind-the-scenes look at therapy, facilitated by Dr. Orna Guralnik. 

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What my clients say…

Wow, what a privilege it is to bear witness to such incredible work in therapy. Here’s what a recent client* had to say about our process:

“I could write an essay on what a fantastic therapist Kirsty is. If you’re struggling and looking to start CBT, I highly recommend her. She’ll listen, offer practical solutions, and help you through your troubles.

Not only is Kirsty very professional, but she’s empathetic, calm and has a great way with words. She listens to what you say, but she always tries to get to the root of the problem. I never doubted that Kirsty wasn’t fully engaged with any of our sessions, but she surprised me with how much information she retained and the way she was able to ‘jump back’ a few steps, pull out information from past sessions and connect it with the present.

I’ve had 15 sessions with Kirsty, and I feel that the work we have done together has been life-changing for me. I value myself more, am able to look at situations more reasonably and I have identified parts of myself that I want to work on to make my life calmer and better. I have stopped using the words ‘should’ and ‘must’ and have stopped beating myself up for not completing a to-do list as long as my arm. 

Thanks to Kirsty, I also have a number of worksheets that I can print off and fill in at any point. Tools that help me reframe negative thoughts, identify negative behavioural patterns and more!

We’ve laughed together, I’ve cried, and she’s listened (I’ve listened too). Sometimes I ranted about how much I hated the world, other times I shared positives and funny stories. But what I’m most grateful for is the safe, judgement-free space that Kirsty created for me, in which I was able to talk about painful, traumatic events that have had a negative impact on my life for 10+ years. I’m now able to ‘revisit’ them at a distance, resulting in fewer nightmares and flashbacks. 

There aren’t enough words to say thank you for what you’ve done for me, Kirsty.”

* These kind words were provided by a client who consented to feedback being publicly shared.

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Could you say no if your life depended on it?

Gabor Maté is an international bestseller and renowned speaker. He’s a family doctor, palliative care practitioner, and psychiatrist. You might have heard of him from doing THAT interview with Prince Harry earlier in the year (which he has since said he regrets agreeing to the associated paywall). 

I initially picked up his book, “When the body says no: The cost of hidden stress” at the airport after hearing Maté speak on the Diary of a CEO podcast with Steve Bartlett where he piqued my interest in his approach to understanding stress and trauma. 

In this book, Maté brings countless client histories and academic research to provide insight on how stress and repressed emotions manifest in common physical symptoms and illnesses including arthritis, cancer, Crohn’s disease, diabetes, endometriosis, fibromyalgia, heart disease, irritable bowel disease, migraines, multiple sclerosis, and other immune disorders and skin conditions. 

Importantly (and thankfully), he also offers guidance on what we can do ourselves to support healing.

Maté invites us to view this information as an opportunity for “awareness and responsibility” as opposed to blame or shame which helps ease discomfort that many a reader may feel when getting on board with the concept that links cancers and illnesses to stress and emotional repression.

Maté brings the reader closer to his perspective by first explaining how emotions interact with functioning:

“Physiologically, emotions are themselves electrical, chemical, and hormonal discharges of the human nervous system. Emotions influence – and are influenced by – the functioning of our major organs, the integrity of our immune defences and…substances that help govern the body’s physical states”.

Secondly, he explains how emotions can be transmuted into illness:

“Repression – dissociating emotions from awareness and relegating them to the unconscious realm – disorganises and confuses our physiological defences…becoming the destroyers of health rather than its protectors”.

Maté doesn’t just consider the mind and body to be linked as this description creates a sense of two entities. Instead, he offers “mindbody” (adopted here throughout) and references Plato’s dialogue to drive his point that mind and body are together as one: 

“This is the reason why the cure of so many diseases is unknown to the physicians of Hellas; they are ignorant of the whole”. 

Here Maté shows us that he isn’t presenting a new finding, that actually the struggle in curing illness was identified thousands of years ago as being the lack of understanding of the mindbody experience. 

Maté points out that associated research was conducted over the centuries, but which seemed to get lost in a “Bermuda Triangle”. 

Fortunately, perspectives are finally beginning to return to this concept and there’s a whole field dedicated to studying “the ways in which psyche – the mind and its content of emotions – profoundly interacts with the body’s nervous system and how both…form an essential link with our immune defences”. This field is called psychoneuroimmunology.

We hear a lot about stress in today’s climate, but do we really know what it is? Maté breaks it down into 3 components: 

  • Stressor: the event or stimulus  
  • Interpretation: processing of meaning completed by nervous system and brain 
  • Response: physiological and behavioural reactions

What this means is that no one event is “stressful”. When a particular event occurs, one person might become highly stressed, another might be slightly stressed, another might not be stressed at all. It depends on how that event is interpreted by the individual, the physiological reaction, and what they do to process it. 

Maté also helps us understand the difference between healthy and problematic stress i.e., acute stress and chronic stress. 

  • Acute stress (short-term stress):
    Something we all experience from time-to-time. It’s short in nature and causes a spike in cortisol and adrenalin with survival being the aim of the game. For example, if you have a fight with your spouse, your stress response is activated which causes you take action to resolve the conflict and return to homeostasis. So, we need our stress response in order to function within our lives and relationships. 
  • Chronic stress (long-term stress):
    Not everyone experiences this. As it is long-term, there is sustained activation of chemicals and hormones in the mindbody – high cortisol destroys tissue and high adrenalin raises blood pressure and destroys the heart. This sends our mindbody into chaos and our immune system becomes susceptible to threat. 
    For example, people who haven’t been taught how to express their needs or boundaries, to say no, or who have lived through traumatic events can live in a constant and chronic stress-state.

Maté skilfully normalises the emergence of disorders and diseases by explaining that people have a “normal response to abnormal circumstances”. That is, if you’ve never been taught how to process and express thoughts and feelings, or there was an extended period of time it wasn’t safe for you to do so, then of course your mindbody reacts with symptoms. Your mindbody is attempting to call to your attention that which is unresolved. 

A final excerpt that I want to highlight can be found in the final pages:

“Emotional competence is the capacity that enables us to stand in a responsible, non-victimised, and non-self-harming relationship with our environment. It is the required internal ground for facing life’s inevitable stresses, for avoiding the creation of unnecessary ones, and for furthering the healing process”.

Quite often I see clients in my practice who are unaware of their feelings or are fearful that expressing their emotions will result in calamity, conflating assertive communication with conflict, and remaining stuck in a stressed state. The reality is that processing and expressing emotions is the key to unlocking experience and building confidence in coping abilities, which is what we work on in a safe way in therapy.  

There are so many concepts that Maté explores: from attachment to autonomy development in childhood, attunement and proximate separation (when a parent is physically there but is for whatever reason not in tune with, or not meeting, the needs of the child even despite their best effort), the power of negative thinking and why being overly positive can actually prevent our healing, internal beliefs, and emotional shutdown and freezing. 

The contents of this book really struck a chord and chimed with my holistic approach to health and wellbeing. Many of us will be familiar with physical symptoms of our emotions: feeling sick with nerves, excited butterflies in the stomach, heart lurching with fright. 

The language we use illustrates that we’re already familiar with our mindbody experiences. Common physical-emotional phrases include “she was red with rage”, “he was shaking like a leaf”, “they got weak at the knees”. We also refer to “gut feelings”, “thinking with my head or heart”, and “knowing it in my bones”. 

You may yourself be someone or know someone who often gets colds and flus or can be floored with viruses and infections. This is commonly the case for those who are chronically anxious or stressed because the immune system is already working very hard to maintain daily functioning and so viruses and infections can quite easily overwhelm the already taxed immune system.  

Running with these familiar concepts, Maté explains how, if we’re in a chronic state of stress and repressed emotions and living out of alignment, our body says what we feel incapable of saying; our body says no by incapacitating us through illness. 

A clear, actionable takeaway from this book is: in what areas of your life are you out of alignment and what could you do to change this? 

Perhaps it goes without saying, but I absolutely recommend this book. Particularly for all you people-pleasers and perfectionists out there, those who have experienced trauma, those who are living with chronic stress, and those who may be disconnected from emotions and mindbody awareness. 

I feel it only right to provide a slight caution for any of you who are unfamiliar with Gabor Maté’s style: he is very clear and concise and although he is not graphic in his descriptions, he is talking about illnesses, diseases, and disorders. I say this not to deter but just for you to be aware as you pick up the book. 

Read this book (RRP £12.99), listen to Maté online (free), and work with a therapist if possible. 

Don’t wait until your body says no. 

When the body says no: The cost of hidden stress. Gabor Maté
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Why do therapists recommend weekly therapy?

Perhaps you want to spread the cost of therapy.

Perhaps you think that it would be good to have the therapist for a longer period of time.

So why do therapists recommend weekly sessions? 

Weekly sessions:

  • Build a strong relationship.
    The relationship between us is incredibly important for this type of work. It’s tricky to build a solid relationship if too much time passes between sessions.
  • Ensure therapeutic work is relevant.
    Life can be fast paced. CBT involves setting goals that you can work towards each week. Goals may lose their relevance if there are big gaps. 
  • Build forward momentum.
    It’s amazing what the accountability of weekly therapy can do.
  • Become your ‘own therapist’ sooner.
    By having a strong relationship, doing work that’s relevant to you, and building forward momentum, you’ll probably find that you’ll be done with therapy quicker than you think and you’ll feel ready and able to ‘go it alone’.
  • Solidify the change.
    Key features of CBT are learning strategies, tools, and techniques alongside meaningful conversation so regular contact is helpful for ingraining the learning and solidifying new neural pathways in the brain.
  • Effective time management.
    In CBT, the therapist and client set an agenda at the start of the session which includes a mood check, any highlights or struggles of the week, and anything that stood out from the last session. So if it’s fortnightly or longer, that starting point can lose focus or become very time consuming which takes away from the session content.


If your main reason is cost: 

Do a little research on prices and save some money BEFORE starting therapy. 

Therapist prices may vary, mine are £20 for initial consultation and £50 for each session. 

My clients currently average 15 sessions in total. 

Budgeting and saving means the money is set aside for you to use for this purpose and doesn’t become a source of stress. 

It should be noted that sometimes pushing out to fortnightly sessions towards the end of therapy can be nice for the client to feel like the therapist is still there while testing the water themselves for any ‘snagging issues’.

And there’s always a degree of flex around sessions as therapist and client collaborate throughout the therapeutic work and there are times such as client and therapist holidays that require sessions to be flexible. 

Of course, if weekly sessions really won’t work for you, speak to the therapist to find a way forward.

Let’s get started!

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Benefits of therapy

Been thinking about therapy for a while? 

Perhaps you think you’re getting on fine without it and feel unsure about rocking the boat.

Not sure what good it would do, if you ‘really need it’, if you’d find any benefit?

Let me talk you through some of the main benefits of therapy:

  • Speak to an impartial, non-judgemental person.

    Sometimes we don’t want to speak about things because we don’t want to be a burden to others, we don’t know how the other person will receive what we’re saying, or it can feel like people we know are too involved in the situation. 

    A therapist is trained to listen and guide in an impartial way that gives you the space to say what you need to say and think about things more clearly.

    You might find that getting things off your chest lifts a weight off you that you didn’t even know you were carrying.
  • Get to know yourself more. 

    You might wonder how you became the person you are, or you might have never had the opportunity to stop and think about it.

    Therapy is an excellent way to pause and reflect, to think about yourself, your likes and dislikes, your current circumstances, your early life experiences, your relationships, what’s important to you.

    Give yourself that chance. 
  • Learn to communicate more effectively and assertively. 

    Communicating clearly and concisely involves conveying your thoughts, feelings, and opinions, making requests, saying no when needed, and dealing with disagreements.

    This is not the same as being confrontational. Effective communication enables deeper and more meaningful conversations and connections.  

    Therapy can help you communicate with confidence. 
  • Learn how to set boundaries with your time and commitments. 

    Sometimes we can find ourselves helping everyone else out and leaving ourselves at the bottom of the pile.

    Initially it can be lovely to help. But over time we burn ourselves out, run out of energy, and resentment can start to build. 

    Therapy can help you find balance so that you can continue to give whilst also looking after yourself.  
  • Move away from ‘fine’ towards calm, content, healthy, and happy. 

    Through life, we find ways of keeping our heads above water, to muddle through, to get on with it, to cope. So you wouldn’t be wrong to say you’re ‘fine’.

    But what if you could be better than fine?

    Therapy helps you prioritise what’s important to you. Acting in line with your values and interests does wonders for your fulfilment and self-esteem. You might be surprised how good you can feel once you’ve got your ducks in a row.  
  • Become empowered with tools to change thoughts and behaviours.

    Perhaps you didn’t realise that you don’t have to continue thinking the same thoughts and doing the same things.

    You are not your thoughts; you can change them. You don’t have to stay stuck in your habits; you can make new ones. 

    Whether you’re a people pleaser, a what-if worrier, a perfectionist, or a procrastinator (or all of the above), you can learn how to work out what’s helpful and unhelpful and how to change in small and sustainable steps.
  • Improved physical health. 

    When you hear therapy, you might think mental health. And you’re not wrong. But therapy can also help with physical health.

    There’s a reciprocal nature between physical and mental health. When our mind is clearer, we’re more inclined to make healthier choices; healthier choices look after our mind.

    Therapy can help you become more active, make healthier choices, learn how to manage stress and anxiety, and can help you with strategies that can lead to improved sleep, reduced blood pressure, a stronger immune system, and stress-related aches and pains.

  • Have time that’s dedicated to you. 

    For some this may seem daunting at first. If you’ve not done it before you might wonder what you’ll talk about for an hour each week.

    That’s where the therapist comes in. 

    It’s the therapist’s job to skilfully guide the sessions and help you open up. It’s different from talking to a friend, this time is just for you. 

Sometimes people aren’t sure if what’s on their mind is important or relevant enough for therapy. 

If it matters to you then it matters.

Therapy can help with all sorts of things: 

  • Managing stress, anxiety, or low mood
  • Improving self-esteem, self-worth, or confidence
  • Processing past experiences, life changes, or bereavements
  • Building more work-life balance
  • Reducing people pleasing
  • Quietening the inner critic or imposter syndrome

The main thing I’d say is give it a go. 

If you try it and decide it’s not for you that’s absolutely fine.

You could try again at a later date, or with a different therapist, or you could simply draw a line under it. 

You’ll only be able to decide if it’s for you after you try it out.

So, let’s get started. 

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What my clients say

Couldn’t be happier to have received this amazing feedback from a client who recently reached a readiness to end therapy:

“My experience in working with Kirsty has been invaluable.

CBT is a challenging but extremely rewarding process that Kirsty made feel achievable.

Completely tailored to my specific experiences and needs, I felt listened to and understood.

The tools I have learnt from Kirsty have undoubtedly changed my ability to manage my anxiety and feel capable of this.

I am eternally grateful for everything Kirsty has done for me.”

This feedback was shared with client consent.

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2023 book reviews so far

Each month I bring you therapy and wellbeing related books and I thought it might be helpful to collate 2023’s reviews so far, so here goes!

Keep your eyes peeled for more book reviews throughout the rest of 2023!

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June book review – Gut Feelings

This month’s book review is by Dr Will Cole, entitled Gut Feelings, Healing the shame-fuelled relationship between what you eat and how you feel. 

Dr Will Cole is a functional medicine expert which means he helps people to naturally and holistically restore health and wellness through diet and nutrition, exercise, environmental factors, emotional support, and other lifestyle concepts with the aim of bringing the body and mind back into balance. 

Dr Cole brings his knowledge and experience to this book to convey: 

  • “The physical and psychological are not as separate as you think”,
  • “If you don’t take steps to improve the health and resilience of your body and your mind, you won’t be able to achieve optimal health and happiness”.  


Cole’s compelling introduction taps into adages we all know – “trust your gut”, and “gut instinct” – and connects to the science by explaining that sensations like butterflies in the stomach is an example of the gut-feeling connection.

The book comprises of nine chapters and provides a framework of understanding of the reciprocal relationship between emotional and physical wellness and how to move towards healthier mental and physical health.

The first three chapters are educational; explaining gut physiology and where emotions come into play, and the manifestation of common gut issues such as bacterial dysbiosis, leaky gut, IBS, bloating, candida overgrowth, and food sensitivities.

Within these chapters, Cole introduces us to his concept of Shameflammation, the “phenomenon of emotional suffering causing physical suffering”, basically that our negative thoughts and emotions are like junk food for the brain and body and keep us stuck living with chronic health conditions including depression and anxiety, low self-esteem, trauma, IBS, thyroid problems, and other immune disorders.

Cole bases his nutritional content on four key principles presented to us with the acronym FLAG

  • Flexibility, curiosity and open-mindedness to learn, 
  • Lightness of passing thoughts and emotions, 
  • Awareness of mindful eating,
  • Grace to move away from shame. 

Chapter four prompts us to consider whether Shameflammation affects our own health through blood sugar issues, thyroid problems, anxiety and insomnia and even hunger and cravings. 

Now we know what’s going on, Dr Cole turns his attention to what to do next in the remaining five chapters on how to feed our guts, brains, and hearts through healthy eating, physical exercise, engaging in therapy and mindfulness practices, using his 21-day gut feeling plan, recipe suggestions, and how to live free of shameflammation by tuning into what works for you. 

Gut Feelings chimes with my personal and professional approach to health and wellness – our emotions, mind, and physical being live within one human body so why treat them as separate entities?

To me it’s only logical to explore, treat, and nourish ourselves holistically. 

In therapy, clients are encouraged to tune into themselves as the expert of their own experience and that’s what this book champions too – take time to find foods and exercise that love your body back and approach yourself with honesty and curiosity as opposed to shame and punishment. 

My main celebration of this book is Dr Cole’s use of language, there are a couple of key quotes that I’m taking away:

“Choosing not to eat foods that don’t love you back isn’t restrictive – it’s self-respect”.

“Accepting your body as it is doesn’t mean you are settling for where you are right now. You are simply shifting your perspective toward making choices out of self-respect and self-love, not out of restriction, shame, obsession, or punishment.”

“Stop saying maybe when you mean no.”

Setting healthy boundaries isn’t rude. Sharing your feelings isn’t being dramatic. Realise that you don’t have to dim your light to make others feel comfortable. You’re not ‘too much’.”

The content is extremely accessible – what we might initially think are complex concepts Cole expertly delivers in a way that makes sense to the everyday person.

It doesn’t feel like a doctor in a white lab coat educating us on the gut-brain axis, rather a knowledgeable friend imparting helpful information so we can all live healthier lifestyles. 

I’m scraping the barrel to critique Gut Feelings however I would pick up on two points.

Firstly, it would be great if the recipes at the back were translated from American English to British English to bump up the accessibility even further. The measurements are in cups and ounces and cilantro is used in many recipes. 

Of course, many of us are happy to hop on Google for any uncertainties but it would have been a nice touch to have a British version to reduce friction for the reader to make changes. 

Secondly, the text is presented in quite a small font which I found challenging to read for longer periods of time.

My copy was hardback so perhaps paperback or Kindle editions would be different.

Overall, I absolutely recommend Gut Feelings if you’d like to understand a bit more about how your emotional and physical systems connect and what to do to find what works for you.

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Can you tell me you feel like sh*t?

YES!

I have no problem with you swearing in therapy sessions, as long as it’s not at me of course.

However, being able to name emotions is one of the first steps to regulating and processing.

So, you can tell me you feel like sh*t and I’ll probably say something like:

  • What does feeling sh*t mean for you right now? 
    (Sh*t can mean tired, sad, guilty, I can’t assume I know what you mean)
  • Where do you notice this feeling in your body?
    (Heavy eyes, knot in stomach, tight chest)
  • What would this sensation say if it had a voice?
    (I need rest, my feelings are hurt, I’ve done something wrong)

Through this process, you give language – and therefore meaning – to your experience. 

This is how you process what’s going on for you. 

So, tell me you feel like sh*t. 

We’ll work out what that means together. 

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What my clients say

I am delighted to be able to share this feedback from a client who recently ended online therapy with me. Sitting in the therapist’s chair is a total privilege, and receiving this feedback is wonderful:

“I came to Kirsty while feeling burnt out and overwhelmed from running a startup. 

Kirsty provided a safe space for me to discuss my problems without any judgment, allowing me to feel comfortable and open during our sessions.

I appreciate how Kirsty helped me with practical strategies to figure out what depleted my energy and what helped me restore it. I felt the space was safe enough to talk about my relationship with my dad, which I had been avoiding previously. 

The atmosphere during our sessions was friendly and relaxed, yet Kirsty skillfully guided me towards understanding my issues and identifying actionable goals.

Towards the end of our time together, Kirsty emphasized the importance of equipping me with the necessary tools to become independent and eventually end therapy, which really reflects her integrity as a therapist.”

This statement was provided knowing that it would be shared on my website and socials and is therefore shared with the consent of the client.