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Mental Health Blog of Dr Finian Fallon, Practice Manager of ABC Counselling and Psychotherapy. All views expressed here are that of Dr Fallon alone.

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Prosody - the Rhythm and Cadence of the Therapist's Voice

Posted on 20 March, 2018 at 11:20 Comments comments (0)

Prosody can be described as the cadence, rhythm or melody of a voice. Prosody is increasingly considered an important element of any therapist’s skill set, which can be taught or at least thought of in therapist training. Teaching and learning this skill is no different to the skill of summarizing, paraphrasing or asking questions. Authenticity in the use of such skills is at the root of their value.

There was a theory that our speech emerged in from the trilling of birds, our evolutionary ancestors. I recall listening to a radio programme years ago that spoke of the gurgling and cooing sounds shared between a mother/ and child and described as “motherese” or “care taker speech”. It appears that children are born with all the components of speech and that they lose some of these as the particular language of their care givers becomes absorbed (after all, we are occupied by language, as the Lacanians might argue). The recollection of the panel member on the radio show describing speech as the “icing on the cake”, after the prosody skills had been learned or shared via the caregiver, has long remained with me. We know from research how a lack of prosody can indicate problems in other areas of childhood functioning, and the relevance of early intervention where prosody problems emerge.

The work of Stephen Porges and others in the field of trauma demonstrates the essential need for safety in psychotherapy treatment. A comforting, calm therapist voice may be one element of helping the clients' brain to enter into a relational frame of mind and reconnect with their cognitive functions in order to integrate or reprocess trauma.

I would also argue that when my voice is calm, and I am aware of this in my psychotherapy work, that I also present as outwardly calm and safe. Also, it seems that in these circumstances, I am more in contact with my authenticity and a therapeutic frame of mind.

In this informative Finnish study of prosody (2014), Elina Weiste & Anssi Peräkylä explore the concept and demonstrate that prosody can be beneficial in both affirming and challenging a client’s perspective. They conclude:

“We have shown how in formulations of emotion, continuing the intonation contour of the client’s talk, combined with a low and quiet voice, is a way for the therapist to preserve the client ́s perspective, and respond empathically to the client ́s emotional descriptions of their difficult experiences.”


Have you considered the impact of your voice and prosody on your client work?

Controversy about anti-depressant medication

Posted on 14 March, 2018 at 7:05 Comments comments (0)

We at ABC recognise the value of anti-depressants for getting some clients through difficult times. If someone is on medication, it is very important not to come off these suddenly without guidance from a medically trained doctor. However, a recent research study has generated a lot of disagreement about how safe these medications really are. Some researchers believe that they are safe, while others insist that they are much more dangerous than has been acknowledged. Some anti-depressant users report increased suicidality, while others believe these medications have literally saved their lives and prevented suicide. There is also contoversy about the side-effects of such medications, with a significant portion of people reporting these including reduced libido or sex drive. Some of these side-effects are reportedly long lasting while others insist that these do not last long. Another dispute relates to the impact of coming off anti-depressants: again there are often two sides to this argument with one side saying the impact of coming off the medications is minimal while others say that the impact of withdrawal can last months or years. Another concept, the idea of depression being caused by an imbalance in brain chemicals. has been shown to be inaccurate and this has been acknowledged by psychiatrists in the UK.

In truth, no one can predict the impact a particular medication can have on someone. It is best that users of any mental health medication inform themselves as to what might be the side effects and impact of long-term use.

Here is a link to the Council for Evidence-Based Psychiatry in the UK which gives one perspective on the recent controversy: