Milton Sattler

Psychodynamic Counselling
Cognitive Behaviour Therapy (CBT)
Gender Sexuality & Relationship Diverse Therapy (GSRD)

A fully qualified, certified, insured and experienced psychotherapist with a demonstrated history of working with mental health and wellbeing in different sectors such as private practice, National Health Service (NHS), the charitable sector and private practice. I am also an accredited member of the British Association of Counsellors and Psychotherapists (BACP).

I offer Brief Psychodynamic Counselling, Psychodynamic Counselling, Cognitive Behaviour Therapy (CBT) and Gender Sexuality and Relationship Diverse (GSRD) Therapy or a combination of them tailored accordingly to the client’s needs.

I offer a confidential, safe, high-quality, non-judgmental and supportive environment, brief counselling and long-term therapy service in English and Portuguese. I think that connecting with my clients therapeutically enables me to fully understand their perception of the key issues affecting their lives.

Services

As a psychodynamic counsellor, I work exploring how your early childhood experiences and early relationships can shape your present relationships and circumstances, creating repeated patterns of relationships. These patterns are still present in your adult life even though you are unaware of them and they may no longer reflect your adult experiences. Being more aware of these patterns and how they impact how you see the world and your position in it will help you to change this perception in a way which assists you better. This may involve uncovering the deeper origins of difficulties by exploring experiences, feelings, dreams, desires and patterns of relating that are contributing to present difficulties. I work one-on-one supporting you to gain a better self-understanding, so you can make more assertive life choices. Counselling could help you understand these problems and help you work with them more constructively. As a Gender Sexuality and Relationship Diversities (GSRD) psychotherapist, I work with clients who are gender, sexuality or relationship-diverse such as Gay, Lesbian, Bisexual, Transgender person, Polyamorous, Asexual, and Gender Queer.

Brief Psychodynamic Therapy

Brief Psychodynamic Counselling focuses on unconscious processes as they are manifested in the client's present behaviour. The goals of psychodynamic therapy are client's self-awareness and understanding of the influence of the past on present behaviour. It enables the client to examine unresolved conflicts and symptoms that arise from past dysfunctional relationships and manifest themselves in the need and desire to abuse substances.

In Brief Psychodynamic Therapy, the central focus is developed during the initial evaluation process, occurring during the first session or two. This focus must be agreed on by the client and therapist. The central focus singles out the most important issues and thus creates a structure and identifies a goal for the treatment. The therapist is expected to be fairly active in keeping the session focused on the main issue. Having a clear focus makes it possible to do interpretive work in a relatively short time because the therapist only addresses the circumscribed problem area.

I work usually between 20 to 25 sessions and then we evaluate our work and decide whether to carry on or stop.

Psychodynamic Counselling

Psychodynamic therapy, also known as insight-oriented therapy, focuses on unconscious processes as they are manifested in a person’s present behaviour. The goals of psychodynamic therapy are a client’s self-awareness and understanding of the influence of the past on present behaviour. In its brief form, a psychodynamic approach enables the client to examine unresolved conflicts and symptoms that arise from past dysfunctional relationships and manifest themselves in the need and desire to abuse substances.

The healing and change process envisioned in long-term psychodynamic therapy typically requires at least 2 years of sessions. This is because the goal of therapy is often to change an aspect of one's identity or personality or to integrate key developmental learning missed while the client was stuck at an earlier stage of emotional development.

A therapeutic alliance requires intimate self-disclosure on the part of the client and an empathetic and appropriate response on the part of the therapist.

Cognitive Behaviour Therapy

Cognitive behavioural therapy (CBT) is a talking therapy that can help you manage your problems by changing the way you think and behave. It is a "problem-focused" and "action-oriented" form of therapy, meaning it is used to treat specific problems related to some diagnosed mental conditions.

CBT is based on the concept that your thoughts, feelings, physical sensations and actions are interconnected, and that negative thoughts and feelings can trap you in a vicious cycle.

CBT aims to improve mental health and it focuses on challenging and changing unhelpful cognitive distortions (e.g. thoughts, beliefs, and attitudes) and behaviours, improving emotional regulation, and the developing of personal coping strategies that target solving current problems.

CBT is based on the belief that thought distortions and maladaptive behaviours play a role in the development and maintenance of psychological conditions, and that symptoms and associated distress can be reduced by teaching new information-processing skills and coping mechanisms.

Gender Sexuality & Relationship Diverse (GSRD) Therapy

Gender Sexuality & Relationship Diversities (GSRD) is a more inclusive term to replace the acronym LGBTQ+. It includes lesbian, gay, bisexual, trans people, intersex, kink, non-monogamies, sex workers, asexual, non-binary and other gender non-conforming people, as well as those who feel generally excluded in discussions of LGBTQ+ issues.

You may be looking for a therapist with training in a variety of specific issues by feeling comfortable working with those who belong to the GSRD communities. I have attended workshops organised by Pink Therapy on the topic of GSRD and Gendered Intelligence (GI) on the topic of working with trans and non-binary clients. I have worked in different GSRD organisations which have specialised work with GSRD clients. I am also a GSRD rights defender and a campaigner for the Conversion Therapy practice ban.
I am also very aware that mainstream psychotherapy has often persisted in focusing on someone’s gender and/or sexuality when it is unrelated to the issue being brought to therapy such as bereavement, depression, and anxiety. Trans and queer people suffer from job-related stress, intersex people suffer from traumatic experiences with correction surgeries, and kinksters suffer from a sense of loss when their children leave home. Often, GSRD clients can suffer from the consequences of homophobia, biphobia, transphobia and internal and external lesbian phobia.

As a GSRD psychotherapist, I believe in working with different tools to better fit to the client's needs. I believe that gender and or sexuality/sexual behaviour is vital to the therapeutic process but I work at the client’s own pace to attend to GSRD-specific issues which the client feels that they need to work with or they feel the need to have a therapist who understands “where they are coming from”.

My pronouns are 'he', 'him', and 'his'.

Straight and working with me!

Being a GSRD therapist does not mean that I do not see heterosexual monogamous clients or that I do not appreciate the way they live their lives. On the contrary, I think that as a psychotherapist I have the privilege of listening and helping those who may have never had the opportunity to talk and to be listened to by others about different aspects of their lives.

Online therapy
I also offer therapy via the internet using a website called Zoom. Online therapy is suitable for a wide range of people and issues.

Areas of Expertise

Depression

A mental health problem characterised by pervasive low mood, a loss of interest and enjoyment in ordinary things, and a range of associated emotional, physical and behavioural symptoms. Depressive episodes can vary in severity, from mild to severe.

Anxiety

An anxiety disorder characterised by persistent and excessive worry (apprehensive expectation) about many different things, and difficulty controlling that worry. This is often accompanied by restlessness, difficulties with concentration, irritability, muscular tension and disturbed sleep.

Social anxiety disorder (social phobia)

Characterised by an intense fear of social or performance situations that result in considerable distress and in turn impact a person’s ability to function effectively in aspects of their daily life. Central to the disorder is the fear that the person will do or say something that will lead to being judged negatively by others and being embarrassed or humiliated. Feared situations are avoided or endured with intense distress.

Body dysmorphic disorder

Characterised by a preoccupation with an imagined defect in one’s appearance or, in the case of a slight physical anomaly, the person’s concern is markedly excessive. Time-consuming behaviours such as mirror-gazing, comparing features with those of others, excessive camouflaging tactics, and avoidance of social situations and intimacy are common, with a significant impact on the person’s levels of distress and/or occupational.

Relationship issues

Fearing intimacy and avoiding closeness in relationships are some of the problems experienced by some people. It can be infuriating and frustrating to feel dismissed and shut down when you try to get close to someone you love. For the avoidant person, you may feel equally confused by the unreasonable emotional demands and neurotic nature of the people you are in a relationship with. “What do these people want from me?” you might ask. You may be accused of not caring and are not there for your loved ones…when you feel that you do care for them and love them greatly.

Another common issue in relationships is unhealthy relationships. It can be very harmful to your sense of self-esteem. It's important to know the long-term effect of negative relationships, how to identify the signs, and how to obtain the help you need to break free from a destructive association when that is the best course of action. I do fully comprehend that sometimes a better action is changing the dynamics of the interaction within a relationship to accomplish the wanted level of stability and compatibility. This can be achieved through a commitment to therapeutic work on the part of either/or all the parties involved.

Identity issues

Developing a sense of self or an identity is a vital part of each process of growing up. Identity or parts of identity may be categorised by any number of things such as religion, race, gender, sexual orientation, culture and so on. Some traits, such as race, are set at birth. Some traits may be changed later in life such as language(s) spoken or religious preferences. Struggling with various parts of identity is natural and normal. Developing an identity or sense of self and those traits a person desires to have can take time and may be challenging. Not having a strong sense of self or struggling with identity issues may lead to anxiety, depression, hopelessness, insecurity, addiction, and more.

Psychotherapy can help individuals to address identity issues and offers a space in which individuals may discuss the issues related to their identity. Through psychotherapy, individuals may reduce their depression, find ways to cope with struggles associated with their identity issues, and ultimately find themselves in the process.

Internalized homophobia

Internalised homophobia is a sexual identity marked by incessant, organised negative feelings, especially shame and self-loathing. The internalization of the dominant heteronormativity culture's attitude is implicit in homosexuals’ feelings about themselves. It is not just about sex but about self-concept. It commences before the consciousness of sexuality and much prior with a sense that you are diverse, and that this diversity is bad and must be kept undisclosed. The LGBTIQ+ child does not fit the hopes of his family, understands that he does not have the correct type of feelings and interests, and feels the ill-defined shame of failure in his very existence, without grasping why or what he has done wrong. Homophobia appears to work as part of a sexual setting, delineating the safe from the dangerous, and is perceived as both crucial and protective to avoid the potential disruption of a heterosexual order. When they get close to another LGBTIQ+ person and begin to appreciate them, they are jubilant, optimistic, and attach to them. Nevertheless, when they realise this relationship can flourish, they retreat and evade, it since intimacy is intimidating for them. This regression makes them feel relieved and feel free about getting away from this difficulty, yet they feel lonely and miserable again. Loneliness pushes them again to a new romance with the same catastrophic consequences. Occasionally this dynamic takes a reasoning system of continuously realising some flaw in their partners such as a bad lover, too young, too extrovert or introverted. Still, the true motive for rejecting promising partners could be self-hatred by the LGBTIQ+ person about not being the man or woman his or her parents and society awaited them to be.

Coming out

Family history and its background are the focus of psychodynamic psychotherapy and can allow an understanding of the internal resistance to coming out. The avoidance attachment is manifest in the infant’s wishes to accomplish autonomy which is spoiled by a fear of abandonment and they keep close to the caregiver at the same time engaging in discovery. The attachment pattern might be an attribute of an LGBTIQ+ person who is not able to assume their sexual orientation and is permanently in emotional conflict.

Self- acceptance

Self-acceptance is not the same as self-esteem. Although self-esteem denotes specifically how appreciated, or valuable, we see ourselves, self-acceptance refers to a far more inclusive assertion of self. When we're self-accepting, we're able to accept all aspects of ourselves - not just the positive, more "acceptable" parts. In this way, self-acceptance is absolute, free of any prerequisite. We can identify our weaknesses, limitations, and imperfections, but this consciousness in no way affects our ability to fully accept ourselves.

People find it difficult to accept some parts of themselves and if they genuinely want to improve their self-esteem, they need to explore these unwanted parts. When we like ourselves more or are on better terms with ourselves we mostly do it with self-acceptance. And it's only when we stop judging ourselves that we can secure a more positive sense of our identity. Therefore, self-esteem rises naturally when we believe more in ourselves.

Self-compassion

Self-compassion or self-love can be a strange concept for some people, especially true for those who were raised in abusive or unloving homes, where compassion may have been absent. Self-compassion suggests how we relate to the self with humanity. It is kindness toward the self, which involves being gentle, sympathetic, and understanding instead of being judging ourselves for personal shortcomings, the self is offered warmth and unconditional acceptance. Having self-compassion means being able to recognize the difference between making a bad decision and being a bad person.

Childhood traumas

Childhood traumas make life for some people very difficult and they may lack self-confidence, skills for conflict resolution, being in love and being successful. It is common but it can have a detrimental effect on people’s lives. Therapy could help you to identify past influences and support you through your journey. It works by respecting your pace and identifying your infant survival skills which may make you stuck in life. It will help you to change these survival skills to more adequate ones.
Some of the negative impacts of childhood traumas are anxiety, being easily emotionally triggered, fear of speaking and identifying their truth, poor boundaries with others, depression, overeating and over-drinking, lack of self-confidence, shame, poor communication skills, lack of conflict negotiation skills, and so on.

Stress

Stress is a mental or emotional tension or tension developed from hostile or challenging circumstances or environments. It happens when we feel exhausted by pressures and demands that we feel impotent to cope with. We feel anxious as a result. Stress arises each time that we are challenged with something unpredicted or frustrating, and we react to the stress on a smaller scale and so we are less likely to notice our stress.

One of the stress causes is people who have taken on too much and find it difficult to stop themselves from doing so. It can be a pattern learnt earlier in life and a psychotherapist will help them to understand the origin of it and facilitate changes.

Bullying & harassment

Workplace bullying and harassment can have a distressing impact on emotional health and your self-esteem but it’s not always easy to know where you can go for some support and a listening ear. It’s entirely understandable that you may not feel comfortable enough to find anyone within the workplace or the university that you can disclose to, especially if you are having some personal difficulties, the working/studying environment is stressful and you are having to face these days by day.

Loss and bereavement

The death of a loved one can be devastating. Losing a job, relationship break-up or retirement all can lead to feelings of loss and bereavement affecting people in diverse ways. There's no right or wrong way to feel.

Talking and sharing your feelings with someone can help. If you don't feel you can talk to friends and family much – perhaps you aren't close, or they're grieving, too.

Bereavement counselling can offer you time and space to talk about your feelings, including the person who has died, your relationship, family, work, fears and the future.