To mark International Women’s Day 2018, we spoke to two of our registrants about their work with women: Nasima Khanom and Erene Hadjiioannou.
Nasima Khanom is a systemic/family psychotherapist and member of the UKCP Board of Trustees. She is also a London Association of Family Therapy committee member and founding Chair of the Islamic Psychology Professional Association.
UKCP Chief Executive, Sarah Niblock, asked Nasima about faith-based therapy and the work she has done following the Grenfell Tower disaster.
Erene Hadjiioannou is an integrative psychotherapist and integrative psychodynamic counsellor based in Leeds.
For International Women’s Day 2018, we spoke to her about her influences and inspiration as a therapist and her work with women with complex needs.
UKCP: You work with women with complex needs. Was there anything that influenced or inspired your work as a psychotherapist?
Erene: ‘There was no single event so to speak. I have just orientated towards what I think is important and what speaks to me as a therapist.
‘I think I have just moved towards areas and topics that I have found interesting or felt really strongly about. Certainly, my most recent roles at Support After Rape and Sexual Violence Leeds (SARSVL), the Rape Crisis service for Leeds, allowed me to align myself more politically as a therapist.
‘There’s a real intuition and passion in me to place myself as a therapist in areas that I think are really important to work on. For me, the work that I do should be much bigger than what I can do in the therapy room. If you’re working with women with complex needs, there’s a lot of political issues that come in there especially around sexual violence.
‘I think I have been able to create a career that really means I can fully use myself with my clients and also outside our work in service for them.’
You view yourself as an activist outside the therapy room. Why is that important to you?
‘I think we are in a really privileged position as therapists, although it’s really stressful when you are the only person who is working with somebody who has all these different needs and you can only address the mental health side of things and your resources or your time might be limited.
‘We live with complexity in our everyday lives, so we need to really engage with it as much as we can in service of our clients, particularly around sexual violence. There is so much focus on the micro aggression that women face and dispelling the myths around rape and sexual violence, I think that’s a responsibility we have outside of the therapy room as well as inside. This is especially important as women will internalise these myths, and these manifest as the blame, shame, and guilt that are seen in a particular way when working with sexual violence.
‘It’s been really awful for me personally as a therapist when I have sat in front of women and they’ve said “the first thing my friend asked me when I told her I’d been raped was how much had you had to drink”, or even a woman sitting in front of a professional who has been a bit accusatory in that sense which reinforces the guilt and shame around the trauma.’
You are an advocate for specialist therapy for women with complex needs. Where does that come into play?
‘I think specialist therapy comes into play when we’re talking about quite gendered issues. Sexual violence for example. The need for women only spaces is an age-old feminist idea, but I think it’s really needed. Certainly in my experience working with female offenders where nearly all of them are survivors, the idea of being in a women-only space was actually really helpful in establishing the effective working relationship that we need to do therapy. Lots of women asked for it.
‘A lot of women have actually said that they’ve been to another service and been allocated a male therapist and just didn’t go anywhere near what they needed to talk about because they felt they couldn’t.
‘We really need specialist therapy that acknowledges all the different dynamics that could potentially prevent change from occurring within therapy. For example, knowing that a woman needs to exist in a world where all these myths around sexual violence exist, and actually have a therapist who can really come from that perspective as well to try and tackle that, will then impact a women’s inner experience on her road to recovery.
‘There’s a lot of aspects and threads to tie together to deliver something that is specialist in a way that specialist should be.’
You have recently finished working with Support After Rape & Sexual Violence Leeds. Can you tell us a bit about your work there?
‘SARSVL started off as just as a helpline service and that service is still exclusively run and staffed by volunteers. They also have an independent sexual violence advocate service which is for women who are thinking about reporting or have reported to the police about sexual violence.
‘They essentially try to respond to the gap in the service provision in Leeds. There are some other women-only spaces that offer counselling for women who have experienced a particular kind of sexual violence but there aren’t really services that responded to every kind of sexual abuse a woman could experience.
‘They got funding to set up the service, which is where I came in. I had to build that from scratch alongside our other two existing services. It really brought home to me how little specialist resource there is for women generally. I met with other service co-ordinators very frequently and it was normal to have 200-300 women on the waiting list.
‘Being able to look back really demonstrates that women came in with all these needs such as housing, childcare, etc. on top of their, mental health needs. All of them showed symptoms of post-traumatic stress disorder, although very few had an actual diagnosis and had nothing in terms of specialist mental health support. More often than not, we were the only service these women were accessing, although within the counselling service we could only assist in recovery from trauma as a result of sexual violence.
‘Very often women had just been round the mental health system and had not found anything helpful, which was much more common in older women partly because of the historic lack of resources and awareness of sexual violence as an issue. University students made up to 25 per cent of our referral base at any one time, and while it’s great that younger women feel they can identify the issue and ask for help sooner rather than later, it’s disturbing to see the continued prevalence of it.
‘There were a lot of different threads that tied together but it was a real experience for me and I was pleased that I was able to set up that service to try and meet the needs of women.’
You also worked with the Together Women Project to offer free psychotherapy to female offenders. How did that come about?
‘Together Women Project works with women in prisons and helps them transition out and be supported in the community in a range of ways. It’s essentially a service for women who have offended or who are at risk of re-offending.’
‘When I set up a specialist service for female offenders I did that completely as a volunteer. I saw the Together Women Project was doing really wonderful work, and they seemed to really try to meet lots of different needs under one roof which attracted me.
‘I approached them and said “I’d really like to work for you, these are the skills that I have.” At the time they had a person-centred counsellor offering brief work as well as an IAPT service but I wanted to offer several months of free psychotherapy.
‘It was more about spotting a need in the community to make long-term psychotherapy accessible, perhaps to women who wouldn’t normally engage with that. I thought if I place myself in that context – in a place where the women are having other needs met – it increased accessibility for them because it’s another resource they can use in a place they know and are familiar with and trust.
‘It was definitely a learning curve. I didn’t turn up thinking that I knew everything and could roll it out. I worked really hard to work in line with the needs of the women to deliver something that they could engage with and felt was really useful and also benefited the organisation as well.’
Do you have any female heroes or women you look up to within psychotherapy or mental health generally?
‘Yes, I really appreciated the work of Estela Welldon when I was working at Together Women Project. She writes from a forensic perspective on women, and particularly during my time there I met a lot of women who had committed very violent crimes. A lot of her work is around challenging the archetype of women as perfect and non-sadistic etc. Actually smashing all those ideas really helped me from a psychodynamic perspective to enhance my thinking around working with these women.
‘Susie Orbach is a very long-standing feminist who has always written and spoken really well about women’s issues, particularly around the body.
‘I definitely quote those two as being an inspiration and support for my work.’
Are there any other issues that you are passionate about or want to highlight?
‘It’s also important to highlight the needs of trans people, non-binary people and LGBT+ people. We still need to fight really hard for spaces for them because I’m aware how problematic it is for them. For example, say we are a woman-only space, what if there is a person assigned female at birth who doesn’t identify as a female? Where do they go for the help they need?
‘There is also something about continuing to extend even if it’s a purely a non-binary space, or a purely LGBT+ space for people. I’ve certainty seen how much harder women who weren’t white, cisgendered and had been living in the UK all their lives, had to fight to get the resources that they needed.
‘I tried to do what I could to get referral pathways in lots of organisations I’ve worked in. But if you’re working with a refugee woman who’s a single mum, has four kids and doesn’t speak English, has no money and is going through the asylum process, it’s so much harder for her to access a service than it is for the white, cisgender student who comes in and knows how to access the service because they need it and feel confident to do it.
‘There is something about building more safe spaces for different kinds of people that respects the diversity of people with complex needs that we need to be reaching out to.
‘Especially because things like gender fluidity, diversity and sexuality are such hot topics at the moment. These people do exist, and they have always done but we are more aware of their existence, so we need to do more, so they can get therapy in the way that everyone else can.’