Since March Headington Psychotherapy has had to go completely online (and unfortunately we had to cancel the training event described in our previous blog). At the moment with the information we have available we don’t see much prospect of being able to go back to face to face appointments before Christmas at the earliest. On a more positive note, we have been surprised by how possible it is to do good work online. I have appreciated and been touched how, in spite of the technical challenges (and often the difficulty of finding somewhere sufficiently private at home), people have been able to connect emotionally and do rich and important work in our online sessions. 

If you are a potential client thinking of booking a session with one of us, the best means of contacting us is by emailing the therapist you would like to see. If you prefer to leave a message on our phone I will of course pass it on. 

It’s been heartening to learn that progress is being made (including here in Oxford) on an effective vaccine that should eventually bring the pandemic to an end. We look forward to welcoming you warmly back into our rooms when that time comes. In the meantime, thank you kindly for your patience and willingness to embrace the technology that enables us to keep connecting. 

James

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Linking with the Flyer I have just published, I am offering some thoughts about a subject close to my heart - applying mindfulness to interpersonal relationships. First I consider relational aspects of individual mindfulness, and then I consider the power and value of bringing mindfulness into relationships. 

Mindfulness is about learning a certain way of relating to ourselves. Specifically, it’s about learning to relate to ourselves with presence and kindness (and for most of us this is easier said than done). We learn to relate to our experience in all its unsatisfactoriness, but emphatically in a compassionate as opposed to a ‘rubbing your nose in it’ kind of way. As a therapist, I consider that the mindful practitioner’s internally directed attitude of presence and acceptance is similar to the attitude of ‘unconditional positive regard’ which Carl Rogers first proposed was the foundation of effective therapy. You could say that with mindfulness we are learning to be our own therapist. 

It follows that learning to be mindful is easier when we are treated in a mindful (i.e. present and compassionate) way by others. Hence, the mindfulness teacher aims to model presence and kindness towards whatever participants experience, including physical and emotional pain, frustration and even boredom. This process is not specific to therapy or mindfulness training. It starts when we are born. Research suggests that mothers who are empathically responsive to their infants help their children to become attuned to and accepting of their own internal worlds: more able to soothe themselves and more able to communicate and negotiate their feelings with others[i][ii]. In my view, it is never too late to learn how to be more of this kind of parent to ourselves. Mindfulness Based Cognitive Therapy (MBCT) is one systematic way of cultivating this. 

Mindfulness can be relational in another way too. There is a strong presumption, both in early Buddhist texts and in more modern, research oriented versions such as MBCT, that being mindful will benefit our relationships with others. With mindfulness we can learn to step back from seeing others through the (often unconscious) lens of our preconceived ideas about them, and, just as we learn to become more present and compassionate towards our own suffering, we become more compassionately open to the suffering in others. Kindness directed mindfully within and kindness directed mindfully towards others are seen as mutually reinforcing and beneficial. An ancient Buddhist text likens it to two acrobats balancing one on top of the other. For them caring for self and other are one and the same thing. As this text concludes: ‘Looking after oneself, one looks after others. Looking after others one looks after oneself.’[iii]

And yet, a number of writers have observed that mindfulness practiced only in an individual format can often fail to generalise to interpersonal situations[iv][v]. The emphasis on silent solitary practice can even, for some of us, reinforce a tendency to avoid dealing with the suffering that manifests in relationship with others. The Interpersonal Mindfulness Programme (described in my previous post) is, I believe, currently the most fully developed secular training in how to build a bridge between solitary mindfulness practice and everyday life, and how to bring the richness of mindfulness practice into the heart of relationship. It was developed by pioneering relational mindfulness teacher Gregory Kramer and Mindfulness Based Stress Reduction (MBSR) trainers Phyllis Hicks and Florence Meleo-Meyer to help graduates of MBSR classes extend what they had learned to their relational lives. In my own experience and the experience of participants in the first Oxford Interpersonal Mindfulness Programme, which I led with my colleague Tanya Lecchi, bringing qualities of mindfulness into relationship turns out to be a deeply satisfying, mutually enriching and sometimes joyful experience. There are some representative comments by participants who completed our first Oxford Interpersonal Mindfulness Programme in July 2019 at the bottom of my previous post. 

It is an as yet unrealised ambition of mine to make available the fruits of an extraordinary 30 year research programme on how therapists and therapy clients resolve relational impasses in psychotherapy[vi][vii]. A central element of this approach, known as Alliance Focused Training, is the art of communicating relational experience in the heat of relational difficulty, a skill of ‘meta-communication’ which is based on relational mindfulness[viii]. A growing body of evidence suggests that what distinguishes more from less effective therapists is the capacity to respond in an affiliative way to clients’ relational challenges[ix][x][xi]. However, in spite of growing evidence for the effectiveness of Alliance-Focused Training in helping therapists turn relational challenges into therapeutic opportunities, to date there has been a dearth of opportunities to train fully in Alliance Focused skills and to the develop the skill of applying relational mindfulness in the challenging relational context of psychotherapy. For some years I have been working with the leaders of this field in the US, Chris Muran and the late Jeremy Safran, and we hope in the next year or so to make Alliance Focused Training available in the UK for the first time.  

James 

A very warm welcome if you are new to these pages and a warm welcome back if you are a previous visitor. 

It is two years since I last posted. Two years! Back in that almost youthful seeming time, I was just about to start a part-time Masters in Mindfulness Based Cognitive Therapy. Now that is over (bar the final verdict) it feels like a moment to gather together some thoughts about what is going on here at HP. 

I’ll share two pieces of news in this post, one positive and one painful. 

Let’s start with the positive. 

Thanks to all clients who took part in the University of Oxford study led by Rachel Evered over the last couple of years. Rachel has now successfully completed her doctorate and over the next months hopes to write up her work for a professional publication. Rachel showed how a brief mindfulness practice at the beginning and end of sessions could help both client and therapist notice and talk about the natural strains in therapy. This in turn, improved the quality of the therapy relationship. To use the technical jargon, the mindfulness exercise helped client and therapist ‘resolve ruptures in the therapeutic relationship.’ If you are a client working with one us, do let us know if you would like to explore doing a brief mindfulness practice as a part of your sessions. Our impression from the research is that it can make a positive contribution. 

We are very grateful to Dr Niels Detert. Niels joined us as one of the research therapists and the study would have been much weaker if he had not generously agreed to do this on top of his demanding job at the JR hospital. Thank you Niels, it was a pleasure having you with us. 

Now for the sad news. My kind and wise supervisor and mentor, Professor Jeremy Safran, was taken from us in May this year. Jeremy seems to have been the unlucky victim of a violent burglary at his home in New York. 

Jeremy’s influence was behind the scenes at Headington Psychotherapy. His work inspired research projects by myself, my colleague Anne-Marie, and students, such as Rachel. Jeremy was the leading figure in a group of therapists researching how ‘ruptures’ are resolved in therapy relationships. In the course of a distinguished career in psychotherapy and psychotherapy research, he made major contributions to the development of emotion focused therapy, interpersonal aspects of cognitive therapy and latterly to relational and contemporary psychoanalytic therapy. 

Having been impressed by his work since the early 2000s, especially his book with Chris Muran on resolving ruptures, I got to know Jeremy personally about four years ago. Fellow Headington Psychotherapist, David Tilbrook, and I organised a therapist training event with him in Oxford. I went on to train with Jeremy in ‘Alliance Focused Therapy’ and he became my clinical supervisor. 

It’s hard to convey to anyone unfamiliar with the world of therapy research what an honour it was to be supervised by Jeremy. I have never before experienced supervision which had such range and depth. Clients who kindly agreed for me to record sessions for my supervision were putting us in good hands! 

I’ll take this opportunity to express my profound gratitude to Jeremy – both for the wisdom of his writing, and the gift of his guidance and friendship. I hope that gift will always infuse and inform our work in Headington Psychotherapy. 

Jeremy’s senior colleague, Chris Muran, has kindly agreed to work with me to help me deepen my understanding of alliance focused approaches. I am very grateful for this opportunity. Our association with this rich, human and deep approach to psychotherapy continues. 

Being based in Oxford, there is a sense of the year beginning in October, as the Universities welcome their Freshers, and the lengthening nights seem to refocus the mind away from the escapism of summer and back to life’s more long-term projects.

This autumn we are saying goodbye to Angela Shanly, who offered couple and family therapy at Headington Psychotherapy for most of 2016. Angela is moving a couple of miles away and will now be based at the Oxford Natural Health Centre (www.oxfordnaturalhealth.co.uk). Her new email address is This email address is being protected from spambots. You need JavaScript enabled to view it.. Thank you, Angela, for your help, and we wish you well in your new base.

Gillian, who reduced her time at the clinic at the end of 2015, is now back and working Monday evenings at Headington Psychotherapy. Gillian is our expert in couple and family work. If you are interested in booking an appointment you can get through to her at her Headington Psychotherapy email address, This email address is being protected from spambots. You need JavaScript enabled to view it..

If you did a therapy with me or with Anne-Marie in 2015, you might have taken part in a study in which Chris Laraway, then a trainee at the Doctoral Clinical Psychology course in Oxford, explored how discussing a short measure of the experience of each session can contribute to resolving misunderstandings in therapy, and help keep therapists ‘on track’ with their clients. Chris successfully completed his doctorate this time last year. His findings suggest that it takes input from the therapist – helping the client feel safe about offering possibly negative feedback, and it also takes work from the client – being prepared to offer that feedback. When both of these contributions come together, then misunderstandings and difficulties in therapy were successfully resolved. If you are a therapist, the take home message, as I understand it, would be ‘honestly encourage your client to express their reservations about you and the therapy’. If you are a client, the implication, I think, is ‘don’t be shy of expressing how you are really feeling about your therapy’. If, as will likely be the case at least on occasion, there is something that doesn’t feel quite right, then do let us know. We actually like this kind of feedback and we trust it will often help us to tailor the work to suit you better.

I have a couple of long-term projects that are looming larger as the nights draw in. I will be taking some time over the next two years to study mindfulness and Mindfulness Based Cognitive Therapy. This has interested me for years, and I see it as increasingly important in therapy. Mindfulness practice is now reasonably well understood and provides a skilful basis for working with difficult states of mind and body. Whilst it overlaps with what we already tend to do in therapy, I really like the fact that mindfulness can be practiced at home as a skill, like learning the violin. We can learn, in quite a structured way, to play the strings of the mind with greater confidence and harmony – and the more regularly we practice, the better we are likely to get. I am confident that the clients I work with who start a regular mindfulness practice in parallel to their sessions with me, increase the speed and effectiveness of the work they do here.

We also have two new doctoral trainees doing their research with us. One of them, Rachel Evered, will be inviting clients in the practice to take part in a study exploring the value of doing a short mindfulness exercise at the beginning of each session. Building on Chris’ work described above, Rachel is looking to find out how clients and therapists might use mindful awareness (coupled with shared reflection on uncomfortable moments in therapy) in ways which help move the work forward. If you are interested in taking part, please feel free to email me at This email address is being protected from spambots. You need JavaScript enabled to view it. and I can tell you more.

If you have made it to the end of this post, thank you for your attention! And best wishes for the New Academic Year.

James

Welcome back to the blog and thank you for reading this far. At the risk of sounding like a head teacher sending out a beginning of term notice, I’m planning to give you one of my seasonal updates on what is going on at Headington Psychotherapy.

Firstly, I would like to warmly welcome our newest psychologist, Angela Shanly. Angela brings enormous depth and breadth of experience to the team, having worked in addiction services, child and family services and physical health settings. Like Gillian, Angela is a highly experienced family therapist (and supervisor of family therapists) as well as being a clinical psychologist.

Secondly, Gillian will be stepping back from the front line of Headington Psychotherapy for a period whilst she juggles a number of other priorities. This means that from now on Angela will be responding to enquiries for help with children, young people, couples and families. I am confident that anyone who finds their way to Angela will discover themselves in the kindest and most capable of hands.

So far, 2015 has been by far our busiest year, coinciding with me starting full time in the practice, and Gillian joining us about then, too. If you are one of our clients, I would like to say a heartfelt thank you for taking your therapeutic plunge with us. There is something beautiful in the courage and honesty involved in opening up in therapy. I know many of you will have been rewarded with new confidence, greater emotional comfort and clarity, and deepening relationships.

James

There’s been plenty going on here at HP, so it seemed like a good time to dust off the blogging software and share some of our news now we’ve arrived in 2015.

Firstly, a big welcome to Consultant Clinical Psychologist and Family Therapist, Dr Gillian Nightall, who, as some of you may know, joined us towards the end of last year. Gillian’s long experience of working with adolescents, families and couples, as well as her expertise in working psychologically with people who have suffered from psychosis and their families, is a considerable boost to what we are able to offer here. Gillian’s arrival means that our clients will be able to benefit from a broader range of interventions and consultations, and we are now able to offer expert help to clients of all ages, and their families. We are lucky to have Gillian join us. Not only does she bring a breadth and depth of understanding based on having trained rigorously both as a clinical psychologist and a family therapist, she is also, as anyone who meets her will discover, someone of exceptional warmth, who wears her expertise lightly and is easy to talk to, even when things are really difficult. Gillian will be working with us part time whilst continuing to work part time in the local NHS secondary care psychological services.

Secondly, this year, in addition to welcoming Gillian, we are considerably expanding our service. I am now working full time at Headington Psychotherapy. It feels liberating to be finally spending all of my time practising what I love in the context we have created here, which is designed to support and nurture the best that psychotherapy has to offer.

Finally, to coincide with our expansion, we have revamped our website, which is now in a format that will be easier to update and edit. We hope you like it.

James

• Center for Alliance-Focused Training - https://www.therapeutic-alliance.org 
• British Psychological Society -  www.bps.org.uk
• International Experiential Dynamic Therapy Assocation (IEDTA) - http://iedta.net/
• Society for Psychotherapy Research -  www.psychotherapyresearch.org

• James Macdonald: £120 per hour 
• Gillian Nightall: £130 per hour
• David Tilbrook: £100 per hour
• Chantalle Berry: £100 per hour

Parking: two hour free parking is available opposite Headington Psychotherapy in York Road. There is unrestricted parking a few minutes away in Titup Hall Drive. 

Address:                                                            
Headington Psychotherapy
110 Old Rd,
Headington, 
Oxford, 
OX3 8SX 

Phone: 07530 194745

Email:

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So, at last the world is warm and light again! Since my last blog we have been joined at the practice by another very experienced clinical psychologist, David Tilbrook. It is a particular pleasure to welcome David to the team. He is a former colleague of ours from the Oxford Health NHS psychological therapies team, and we had hoped when we first started Headington Psychotherapy that David would be able to join us here at some point.

David’s work is characterised by a sensitive appreciation and exploration of the therapeutic relationship and other relationships both past and present.  This makes a lot of sense as most psychological problems have roots in the compromises we make in order to get on with the people we need and care most about when we’re growing up. I have had many case discussions with David over the years and can testify to his consistent thoughtfulness and compassionate commitment to his clients. For more on David and his approach check out his entry in the ‘who we are’ section of the website.

18th July 2014

My last blog was way back in June. How swiftly time and the intention to blog speed past!

Now we are in November, we’ve had our first frosts, and many of our sessions are in the hours of darkness. Hopefully, our clients experience the Headington Psychotherapy rooms as places of warmth and light as the world outside cools towards Christmas.

Our main news is that we are welcoming a new psychologist, Chantalle Berry, into the practice. Chantalle has a doctorate in Counselling Psychology and she will be offering evening work. We hope this will help us meet the needs of those of you who need to work between the hours of nine and five. Chantalle is very comfortable working with the most common problems in adult mental health. She also has specialist experience of working with addiction problems and people with learning disabilities. For the last few years she has been a highly valued member of an NHS psychological therapies team (I know, because I have worked there myself!) Chantalle will be an excellent choice of therapist for anyone wanting a committed, empathic therapist who is adept at tailoring therapeutic approaches to fit individual needs.

Chantalle’s details and Headington Psychotherapy email address will shortly be added to the website. In the meantime, if anyone would like to enquire about her availability for either an assessment or ongoing therapy, you are welcome to email us at This email address is being protected from spambots. You need JavaScript enabled to view it.

James

17th November 2013

Thank you for taking the time to read this far into our website. At the time of writing, both the website and Headington Psychotherapy are new arrivals in Oxford (although both of us have worked locally in the NHS for many years). Over the last two months we’ve been busy setting everything up. We’ve had the whole of our offices at 110 Old Rd repainted and re-carpeted. We’ve also had wooden louvre shutters put into the windows of our two consulting rooms to ensure that the space inside feels private whilst letting in plenty of natural light. Later this month we will be getting a state of the art computer system that will enable our clients to track their therapeutic progress over time using brief ‘outcome measure’ questionnaires. In short, we are now open and fully equipped for the real business of helping our clients!

If you are a potential client looking for therapy, we recommend an initial ‘try out’ of one or two sessions of therapy – at least one of them being an hour and a half or two hours long. This is usually long enough to come to a mutual understanding of the nature of the problem you are struggling with and how therapy can help. Now is a great time to book a ‘try out’ as we are just beginning to build up our caseloads. At the moment, we can offer appointments on Fridays within two weeks of your enquiry. We have some early morning and evening appointments available if you are unable or unwilling to take time off work during the working week.

Please feel free to contact us for a discussion of what might be involved if you are contemplating therapy but unsure about taking the first step. We are approachable and willing to signpost you to different services if we do not think we are best placed to help you. Emailing us is best in the first instance (our email addresses are in the ‘contact’ section of the website), but following this we are happy to set up a phone call at a mutually convenient time to talk things over with you.

James

1st June 2013

At its most basic, a therapeutic conversation involves opening up to another person (in this case the therapist) about what is most troubling in one’s life. The therapist is trusted to respond as empathically as they can and to keep the conversation private. Empathic, trusting and disclosing relationships of this kind are the basis for emotional growth no matter whether this occurs in therapy or outside therapy. In feeling valued and understood, we are more hopeful that there are solutions to our problems, we are more likely to see new perspectives on our problems, and are more likely to involve ourselves in new opportunities for learning. In fact, the more one has access to relationships of this kind in one’s personal life, the more protected we are likely to be from psychological problems in the first place, and the less likely we are to need professional help.

Professional therapy adds to this in a number of ways. Firstly, the therapy situation has boundaries which protect the ‘therapeutic’ nature of the conversation. The therapist is and remains outside the client’s social and family life, the therapeutic time is clearly defined and protected from intrusions, and the therapist focuses on the client’s life (rather than talking about their own life, for example). These boundaries aim to create and concentrate the conditions for emotional growth in the therapeutic relationship. (Of course it is also necessary for the client to use those conditions to help them face their difficulties). Secondly, the therapist offers their knowledge of tried and tested methods for resolving psychological problems associated with the approaches to therapy in which they have been trained. For example, the therapist can offer the client techniques for managing or exploring troubling situations, offer new understanding of the problem, use the therapeutic relationship to support new learning about the client’s self, feedback on the client’s progress and so on.

We hope that this brief, simple explanation of therapy is helpful. The ‘therapy world’ in the early twenty first century can be somewhat confusing. There are at least 400 different brand names of therapies in existence (e.g. cognitive behaviour therapy, psychodynamic therapy, cognitive analytic therapy, etc.). However, researchers who have compared different models of therapy tend to find that there are no differences in effectiveness between different approaches to therapy. It is therefore likely (a) that different approaches suit different people and (b) that in spite of the differences, there are some core psychological processes that are present to a greater or lesser degree no matter what kind of therapy is being used. Such processes are likely to include feeling more hopeful that there is a solution to one’s problems, facing and mastering feared situations, becoming more accepting of one’s emotional experiences and so on. We do know that the quality of the therapeutic relationship is one important element in most successful therapies (which is why it makes sense to ‘monitor’ this formally at the end of each session). 

We often suggest that you start with a longer appointment of one and a half to two hours. This enables you to describe your difficulties and the background to your difficulties without feeling rushed and to begin the process of building rapport with us. This also enables us to share some initial impressions with you, which can help you consider new perspectives on your difficulties and build motivation for the therapeutic journey ahead. In the first appointment, we will ask you to talk about the problem or problems that you are hoping to resolve, and will ask you to talk in as much detail as you can about times when the problem has been difficult. We are likely to invite you to explore life experiences and relationships which may have influenced the development of the problem.

At the beginning of therapy, we will ask you to fill in a questionnaire that covers many of the commonest symptoms of psychological distress. We will review this form with you, usually at the beginning of the second session. The aim is to clarify more about the nature of your distress. This first form will also provide a comparison point for repeated use of a short symptom questionnaire which can help us track your progress in therapy.

At the end of the session, we will invite you to review your experience of the session, covering issues such as the extent to which you felt understood in the session and whether you agreed with the approach taken by us in the session. This is to help us tailor the treatment specifically to you, and can also act as a very helpful indication if for any reason you are not feeling comfortable in the session.

Future sessions can be either one hour or one and a half hours long. They are usually scheduled either weekly or bi-weekly (though sometimes monthly for family therapy). The beginning of each session will be devoted to a review of your progress in therapy. The end of the session will involve a review of the session, as described above. The work in the main part of the session will vary in its focus depending on what is required and what you bring to the session to work on.

Length Of Therapy

This varies according to the wishes and needs of each individual. In general the range is between twenty sessions to fifty sessions though family and couple therapy tend to be shorter, generally between four and twelve sessions. As progress is reviewed at each session, we do not encourage you to stay in therapy for longer than is beneficial or necessary for you, and the duration of treatment is something that can be openly discussed (and reviewed) at any point in the therapy.

We provide individual, family and couple therapy in a comfortable, private setting in Headington, Oxford. We are experienced professionals who have trained in more than one model of therapy. We try to use the best of different approaches to meet your needs. James works mainly from a psychodynamic and humanistic base, Chantalle from an integration of cognitive behavioural and psychodynamic approaches and David from a broadly psychodynamic perspective. Gillian works from a family therapy and systemic perspective as well as offering cognitive behavioural therapy*.

In practice, we use the techniques that we believe are best suited to you. We regularly request that you give us honest feedback on your progress and how you are finding the work with us. This is so that throughout therapy we can tailor our approach to your unique situation in order to help you get the most out of your investment in therapy.

* Very briefly, for those for whom these terms may be unfamiliar: ‘Psychodynamic’ therapy has a focus on our history of relationships and how relationships have shaped the ways we cope with our emotions and the ways we connect to ourselves and others. The goal is to have a ‘corrective emotional experience’ in therapy. ‘Humanistic’ therapy emphasises the innate tendency people have to grow emotionally and stresses the value of empathic listening, and the healthy expression of emotions. ‘Cognitive Behavioural Therapy’ is based on exploring and testing out beliefs that contribute to psychological problems. It tends to involve a practical focus on monitoring and challenging unhelpful assumptions. ‘Systemic’ therapy involves exploring and working with the patterns of communication in families, couples and groups and is used particularly in family and couple therapy work. In practice, there are many overlapping elements in these approaches, but they also have distinctive assumptions and practices.

We are a forward thinking psychotherapy service providing individual, couple and family therapy. With us you can embrace the challenge of therapy in a supportive environment, with experienced, highly trained psychologists.

Our aim is to work with you to create the safest environment possible to face and tackle the problems which have been troubling you. We believe there are many approaches to solving psychological problems, depending on your own preferences, the nature and duration of the problems and the impact they are having on you.  We are all trained in more than one approach to therapy and try to use the best of different approaches to meet your needs. 

In order to make sure that our work is helping, we will invite you to 'track' your progress by filling in a problem questionnaire at regular intervals. This helps us to get the therapy right for you and supports your active involvement and commitment in everything that we do.