OK, NOT-OK in time of Pandemic

This article appeared first in a shortened fashion on The Psychologist.

In these difficult times where an ugly mix of clarity and confusion is making everyone to obsessively google COVID-2019, pandemic, washing hands, coronavirus and so on, something triggered my mind. Throughout last week, I started reflecting on the importance of guidance in stressful times… and there it was: the absence of the “archetypal father” (Jung, 1948). With this term, Jung identified al the aspects that a father figure might have: strength, protection, and authority, and the lack of it in the case of its dark side.

At the beginning of my training in TA, the whole idea of OK-ness shocked my understanding of the psychotherapeutic process. This term defines the inherent sense of being enough. I have been trained as a Clinical Psychologist with an orthodox psychoanalytical understanding of mental health: the idea seemed alien to me. Yet as in every love story, I started flirting with it, trying to investigate its idiosyncrasies and complexities, feeling my system slowly warming up to it, and beginning to see its value only when I decided to take it out in the world. I can’t say I wanted to marry it straight away, but I decided to move in with it, and take it from there.

It’s working, thanks for asking.

My understanding of “I’m OK, You’re OK” is more existential (English, 1975) than practical, yet its outcomes have a more than a theoretical effect on what I do or don’t. People acquire a Life Position (Harris, 1967) and usually codify and interpret the world from this existential lens, rather than passively absorb the world.

In these difficult times where everybody knows COVID-2019 and is on high alert whenever a cough is heard, I think that the worldwide societies are facing their existential position right now, and this is evident by the variety of responses that we all are able to see happening in the world.

I am going to ask to put on some glasses, and see the world using this simple tool: “Am I considering mine and people’s condition right now? Do I consider others as worthy of OK-ness as much me?”.

Epidemic and Pandemic as Losses

Being the person that I am, I can’t refrain from looking at the world with some curiosity. I recently started to consider both the concept of Loss and its role in systems.

Losses happen whenever something or someone disappears, ceases to exist or becomes infinitely distant from us. I don’t think that there is any “recovery” from loss, as usually the lost object/person is not going to come back anytime soon. It is all about reshaping our life after the loss, and the only way to do it is to feel the loss in small bites, as small as affordable by the person.

Every loss makes us rethink about our existential position towards ourselves, others, and the world. Traumatic Losses do this even more effectively, potentially shattering our hardly earned safety into disintegration, pushing towards confusion and reaction, rather than a calm (Adult) analysis of our surroundings.

The safety-seeking response

When under pressure, people use their own shortcut to safety, their (almost literally) survival decisions and strategies. It is unsurprising then, that the average reaction we are seeing is on the lines of “every man for himself!”. It is such a human reaction to have when faced with an invisible, relentless, threat like coronavirus: a flu virus different enough from other seasonal flu viruses to quickly and effectively spread. We are now faced with existential anguish and threat: an invisible attacker that can become anyone, especially who we don’t know.


All of us living in the UK have done some thinking about this virus, we are forced to by what is happening in Italy right now and its drastic measures.

It’s disturbing to see the fear spreading quicker than the virus, the “You’re not OK” part of the equation is evident in the fellow passenger with darting eyes who changes seat in the bus as soon as you cough, the fellow tube passenger who gets out of the train 4 stations before their destination after hearing a sneeze. Well, the lack of passengers in the trains speaks loud about fear.

The group pressure on the individual

We are born in groups, and it’s to our group where we go to find shelter when feeling unsafe. From the group we receive the promise of protection, the “We’re OK”.

Unfortunately, this becomes a problem whenever the group leaders show denial or minimisation of problems, perpetrating narratives that are not in line with the here-and-now events. As in dream-like states where things have little-to-nil consequence in the real world, some leaders respond to losses of safety with a disorganised attitude of freezing, Discounting that results in neglect, and a false sense of safety that does not match the experience of the individual.

This is the confusing birth of a deep rift that can go anywhere.

Confusion is the main experience, at all levels. In the immense and intricated system where we are as humanity, a pandemic it’s an invitation to get together and collaborate. Despite the WHO shift from epidemic to pandemic, a loud silence has been heard. The group leaders, from governments down smaller systems, have offered individual responses to a systemic problem which is a statement of the current “free-for-all” general attitude. It seems apparent that the feeble “wash your hands” indication provided might not cut it.

Individuals generally tend to respond with stress-responses to the confusion at the top, showing a great deal of “selfishness” and split from their peers, which is one way to interpret the emptiness of shelves in supermarkets, and the unthought endangerment resulting from the sudden escape from the “red zones” seen in Italy. Furthermore, once fled people feel safe, as they crave for it, detaching themselves from the problem.

A confused and confusing response to a pandemic can make the individual shift towards either the “I’m OK, You’re Not OK” or the “I’m not OK, You’re Not OK” positions. What is in common between these positions is that the others become enemies or not relevant, dehumanised, therefore not worthy of care.

The unthought processes shut down logical and empathic thinking, resulting in further spreading of the pandemic.

Responsibilities: shared and individual

Leaning on laurels is the normal responses once the cortisol-driven amygdala biochemicals have worn off. Once “safety” is achieved, or assumed to be, relaxation is the next phase.

Here is where the problem lays: the “We’re OK” narrative that neglectful, unthought responses create.

The bystander effect [Clarkson] is rather known, and one thing is clear about it: it’s not a good thing.

While some passivity from the top pushes people on the bottom into action, I still believe that this is not a gamble that any of us can afford right now. It falls on the individual to make a personal assessment regarding their responsibilities, unfortunately. It would be good to receive guidance from people who are supposed to provide some, yet at times we must let go of the idea of a better state-of-things, the current loss bargaining, and look at what is happening with Adult, here-and-now awareness.

Shifting towards “I’m OK, You’re OK”

My invitation is to all the other humans to consider people who are endangered by this once-epidemic-now-pandemic: the immunosuppressed, the older, the frail, the health anxiety sufferer, the germophobe, the irresponsible, the “don’t care” type.

“I’m OK, You’re OK” is an ethical stance, a statement towards the fellow human being and their existential condition, not just a “love for all” flowery sentence that brings nothing to the table.

As an Italian man, I feel under the “You’re Not OK” part of the corral. From “pasta-eater” to “plague-bringer” is a huge leap. The “archetypal father” is not providing guidance because of his denial, so the neglected children are taking it on to each other.

As a professional of mental health, I am asking all my peers to take this coronavirus seriously, and to invite the people you are in contact with some reflection. This is a responsibility we all share towards others, the ones we know and the ones we don’t. There is nothing worse than being silent or passive right now.

I invite organisational bodies, employers, regulators, statespersons etc. to provide some directions to all of us and take this issue seriously, as what is at stake is much more than money.

Reality is, we are all in the same boat together.


English, F. (1975). I’M OK—You’Re OK (Adult). Transactional Analysis Journal, 5(4), 416-419.

Harris, T. A. (1967). I’m OK, You’re OK. New York: HarperCollins Publishers Inc.

Jung, C. G. (1948). A Psychological Approach to the Dogma of the Trinity. In G. Adler, & R. F. Hull, Collected Works of C.G. Jung (Vol. 11, pp. 107-200). Princeton, NJ: Princeton University Press.

Perfectionism: Are we all just imperfect perfectionists?

Introduction and aim

Who knows what perfection is, really?

I clearly know that this article would not be perfect. Just enough.

Without going too deep in the philosophical part of this, let’s just say that if something is perfect it is definitive as well, it screams “No more!”… and this is the con I am going to put my finger on. The strive to achieve the unachievable causes anger, dissatisfaction, self-deprecation and disappointment…sometimes, self-disgust.

So much, isn’t it?

Being a relational psychotherapist, I will use this frame of work and Transactional Analysis language.

Perfection – Imperfection: a change of perspective?

In Psychology, Perfectionism is split in Adaptive and Maladaptive. The second one is the one that causes self-defeating strategies and self-fulfilling prophecies, while the first one should be the one that helps us focusing and working hard to achieve what we want.

I don’t buy this: this term can only trigger pain if applied to people, like you and me.

The etymology of the word Perfect says it all: from the Latin Per (Completely, thorough) plus Facere (To do). “Completely done” then, without any need of further modification. If this can be applied to production processes, it certainly cannot apply to anything qualitative.

What I mean here is: if a part of you believes that you need to put all your effort becoming perfect, it is implying that you are imperfect (or defected) right now. Ugh.

How could anybody be completely done and not in need anything else?

Here is a fitting visualisation: Zeno’s paradox, Achilles and the tortoise. The paradox says that, regardless of Achilles efforts and his athletic skills, he will never reach the tortoise because of the advantage he has given to the animal. For every step forward Achilles might have done, the tortoise has done its equivalent: the points will never merge.

This is absolutely true because we are considering only one dimension: distance. Getting from A to B, here to there.

Hey, it’s a paradox.

This is what perfectionism makes us to do: never consider the process of getting there, the time involved, the bloody effort.

The main problem here, is to redefine what the Perfection – Imperfection dyad means.

The cognitive bias a perfectionist will incur in, is to consider that things have only two statuses: complete or incomplete, finished or unfinished, done or not done. A perfectionist will see the two statuses absolutely far away, not considering the effort needed or the necessary time involved.

Let me introduce Nicola, a nickname, who came to therapy because he was never satisfied with his achievements. He arrived in London at the age of 24, worked as waiter and landed a job in Marketing 6 months later. Great, he thought. When I met him, he was earning a reasonably good salary, and going up in his career towards becoming a manager. The anger, self-deprecation and frustration he expressed in every session were intense. In his mind, becoming 28 and not being a manager was shameful, especially in light of other people’s promotions. To him, whatever he was doing in that moment was worthless if the managerial position was not achieved.

Or manager, or nothing at all!

With the following sessions, appeared evident to me that Nicola would have not been satisfied even with becoming a manager. “I mean”, he said, “if I can obtain that in such a short time, I could push for more.”. Here we are to the core part of this: the self-deprecation. The person believes that if getting there is at all possible, there should be something else to get to much better than that.

In Transactional Analysis, this configures itself as a Driver that a child makes in response to the parenting style received. A Driver is a specific interpretation of childhood that allows you to keep going, part of the strategy you made up to ensure you would have received love. It is comfortably called “Be Perfect”.

This is how I imagined Nicola’s perfectionism:

When I shared my thoughts with Nicola, he did not take it well. In his mind, I was basically saying that either his aims were wrong, or that he would not be able to achieve them. Except that I wasn’t: Nicola was projecting his demanding Parent on me, so the only angle he could take was of me pressurising him “to make it right”.

This little rupture in the therapeutic relationship, and its resolve, helped Nicola to feel the weight of endless hours of study he did alone when he was a child, the effort he put in obtaining badges as scout, the strain in checking every single detail of the event he organised for the church, the mind-reading he did with his friends to anticipate their need and satisfy them without question being asked.

All this to be neglected, to self-neglect, to confirm his unworthiness.

Perfected Imperfection: when enough is enough

If we consider for a moment what kind of pressure Perfectionism produce on one’s psyche, we have to take in account the payoff that this provides for the person. As every defence, it comes up when an individual feel threatened or under attack. There isn’t anything worse for a child to feel threatened, to feel unwanted or unloved. That’s death, simple as that.

The various systems we are immersed in (just to play a bit of name-and-shame: school, religion, culture etc) can all feel very demanding to a small child coming to the world without much of a knowledge. The world need to be digested and interpreted for him/her, because it is a lot to take in. If the parents cannot mediate these information in a non-threatening way… well, here we are.

Far for me taking it only on the parents, they have tried their best. They did what they thought was necessary, what felt enough to them.

Oh! What have I said? Enough?

Nicola started to reconsider events and his life position. He discovered that as defence he showed to be confident and all-around angry when the big people did not allow him to become manager, and yet he felt very small inside.


Just you, just me

Therapy can help people to just accept who they are and where they are in life, without judging themselves. I’m OK, You’re OK. Exploration of OKness seems to be the key.

Nicola saw where he was in life: he was only 28, with a good salary, a track of successes, a somehow good career in front of him.

Not too bad, isn’t it?

Not a great philosopher, but a revolutionary artist completely misunderstood in his times said “Great things are done by a series of small things brought together.”. This person was Van Gogh, probably one of the artist who showed how mental health difficulties can be used to create something unique.

In therapy, we considered for more than 9 months the reasons why his career was “stuck” and he found out that, sometimes, the adult world sucks. Internal politics between managers was keeping him down.

He changed company.

A simple step that meant so much for him: “It’s not me, it’s them!”.

Yes, Nicola. You’re very right.

This is how our deeper journey started.

This article is firstly appeared on The Counsellor Cafe.

December Blues: 5 Tips

There is a usual chain of thoughts that appears in everybody’s mind as soon as December starts here in the UK.
December means cold, darkness, pubs, drinking, happiness, friends, family, food, more drinking, holidays, Christmas, flights, home.
Depending on where you come from or your life experiences, your personal train of thoughts can be slightly different or have little in common with the one I have proposed above, but some of the words I have mentioned will be present in your mind: Family and Happiness.

Not necessarily in a good way.

These words should evoke positive feelings, or at least this is what society expects for everybody to happen. Reality tells us that there is instead a great increase of people reporting feeling depressed or anxious as the festive season approaches. You might find yourself thinking about starting psychotherapy, and for a good reason.

Part of the explanation lies in the huge strive for all perfect things that have to be part of the experience: the perfect gift, the perfect party, the perfect gathering with friends, the perfect end and/or perfect begin of the year. These things, either self-induced or born out of society pressures, make life very difficult for the ones who are struggling with challenging situations. They are much more than you might think.


The loss of a job, or not having the proper one, missing family and friends, feeling isolated and alone in dealing with problems, financial issues, remembering the death of somebody are all factors that might send your mood in a dangerous downward spiral. Especially for those who have lost a dear person, the emptiness a loss leaves behind will be much more emotionally evident. Finding yourself looking at pictures, remembering usual phrases, favourite dishes or missing rituals can be deeply painful. It really does not matter how much time has passed, there is always a part of us unable to understand time.

While for some people this might trigger stress, for others anger and depressive states get to the surface, especially when loneliness is part of every day’s experience. December seems to be triggering self-reflection in many people, ruthlessly called rumination by some, which can easily target life’s inadequacies.

5 Tips:

If you find yourself having troubles sleeping or waking up, eating more or less, feeling fatigued by all the things you have to “get right” before the end of the year, you might want to consider following these 5 tips:

1. Resize your expectations

Regardless of whether you stay in the UK or reach your family, you cannot make everybody happy. Christmas, as life, is not like one of these amazing cards you can find on sale in shops. Just take it as it is, with its joy and sadness.

2. Focus on what is important

Spending your energy chasing perfection is a perfect recipe to come short and missing out. Who cares what Christmas’ traditions dictate? So what if you cannot find the right gift for that friend? Give yourself a break! Stressing yourself about these things will only put yourself down. Is this what Christmas is about?

3. Reach out your support system

We all need somebody else to cope with life. A friend, a family, a group. Break the barrier and make that phone call, send that email or ask to meet up. Being alone will only reinforce your depression and anxiety, your belief of being useless or bad. Try to keep the balance asking for help.

4. It does not have to be that bad!

Expecting catastrophe will just make you have awful experiences. Your brain can easily trick you through what is called selective attention: when you expect bad things to come, you will never see the good ones. What if this time everything will be different?

5. Time for a change?

December and Traditions are two terms with thousands of years of history between them. If you are dreading something about the usual festive drill, something you really do not want to do, what if you just don’t do it? What if you make it more OK? Nothing major, but you deserve to enjoy life.

If you want to know more about the biochemistry involved, please visit PhD Student Alessandra Donato’s blog.

If your mood is putting you down so much that you feel hopeless, or that nothing will work for you, please consider seeking professional help. Psychotherapy might be more helpful than you think, it is really not a shame to feel how you feel.

Nobody has to be alone, even less in such a difficult month as December.


To feel anger, To be angry, To act on

Anger is a common emotion we all feel from time to time, and is healthy.

I think it is important to clear the air right from the beginning, because having confusion regarding a common emotion can easily lead to self-judgement and self-actualizing prophecies way more damaging than anger itself.

Whether anger is triggered by a partner leaving the bathroom in a complete mess again, by the traffic that makes you late or somebody lacking respect towards you at wok or in your intimate, it remains an emotion you need to express at that time. And that is fine. Anger is an emotion our brain, over millennia of development and neurological refinement, uses to provoke a status of general activation leading to an action, generally in response to something perceived as bringing dissatisfaction or worse. In other terms, anger allows us to do something and change the status quo.

Put this way, anger sounds much better,  doesn’t it?

Anger can become a real problem when it comes to express it. If having emotions is natural, expressing them is the rocky part. In a following article, I will be speaking about the difference between Anger and Rage, deeply important in terms of therapeutic strategies and management. By now, what is relevant to the aim of this article is to bear in mind that Anger can mutate in overwhelming Rage, and this is where an issue can become an unhealthy problem.

It is possible to distinguish two different ways people use to express anger: Internalizing it and Externalizing it.. Another way to say it is Anger-out or Anger-in people.

The people who adopt the first strategy tend to suppress their anger and bury it inside them to the point that they do not recognize it anymore, and it may lead to withdrawal and depression. It is very common for Anger-in people to be scared of their own anger, usually perceived as dangerous and inappropriate, and they are usually deeply ashamed of it. If Anger switches to overwhelming Rage, mostly because of the social isolation it leads to, one of the unfortunate versions can lead to self-harm and even suicide ideation or worse. The reasons why people internalise anger to this point are thousands, from gender-appropriateness to family patterns, but they are certainly treatable. Communication is one of the focal points in these cases.Standing Ground

On the other side of the river, there are those people who externalize it, the Anger-out group, who find very difficult to keep this emotion inside. The way accessing their anger is so easily embarked that there can be a confusion and, as for the Anger-in group, a lack of recognition, that can easily lead to use anger as standard response to any stimuli presented. Anger can quickly become totalising. People experiencing this way to express anger can find themselves isolated because the people around are afraid of outbursts, or because of the shame following embarrassing arguments. If Anger turns in Rage, they may become aggressive, verbally or physically, either against people or against objects, feeling absolutely out of control and preys. This can seriously endanger either the person or the people around. Again, acknowledgement and communication of the issue can ease the path towards the management.

Whether if you are an Anger-in or Anger-out person, you may find very difficult to soothe yourself and having to deal with an awful lot of shame.

If you feel like exploding many times during the week, or with some specific people or within certain relationships, you might want to consider those general pieces of advice:

  1. Walking away from the situation: this is one of the most common and useful strategies when a situation is triggering you. If the reason behind your anger is a person, tell him or her that you are going off for a couple of minutes and will come back once calmed. Regardless if this person is your partner, a colleague, a friend or a family member, this strategy tends to work quite well.
  2. Thinking through: you might want to adopt this strategy when you still feel angry, but slightly calmer and in control. Thinking and walking, in other terms redirecting your energies, will help you to analyse what is happening to you and have a better understanding of it. Even better if you manage to do it with a person you trust.
  3. Communicate: whether if you are feeling your anger bubbling up or you are in the heat of the moment, remember to communicate what is going on for you from the “I” perspective. Anger, and especially Rage, tends to lead us to blame others for the anger we are feeling. That can easily be true, somebody can actually make us angry, but it is fundamental to learn how to express what we are feeling right now. It will ease the path towards calm.

Those are only few tips you may want to try out when the anger is in the mounting phase. If you feel that you anger tends to be overwhelming quickly, you feel angry all the time or your anger has much deeper roots you need and are willing to explore in a confidential and non-judgmental environment, you may want to seek help for it. Psychotherapy or Counselling can be what you are looking for, in the form of anger management therapy. Together, we will look at the triggers, the reason why anger is the strategy you adopt and work on some strategies enabling you to restore the calm in your mind and body.


Starting the Therapy


Deciding to start therapy is a very challenging and nervous time.

Regardless of the reason why one takes this decision, the act itself requires a considerable amount of bravery and insight. I believe that there are 11 things which might be helpful to you if you are new to, or thinking about, therapy.

1. Therapy has to be a personal choice

The main reason why many therapies fail, in my opinion, is because people start therapy because “told” to or for others’ benefit other than themselves. If you start therapy out of duty to somebody else rather than for yourself, you are only setting up a failing self-actualising prophecy because you will never get the most out of the process. Undoubtedly other people will receive benefit from your therapy,  but it is important to understand that therapy is a personal commitment and has to feel right for you and you alone.

2. Therapy is different because people are different

It is my deep and personal belief that it is impossible to have two identical therapies. My belief stands against the most structured therapy as well as the least one because it is based on the simple fact that every human being is different. Every human relationship, included a therapeutic one, is overdetermined by myriads of factors put in place by the incredible diversity the human being holds. The best option in starting a therapy is to call few therapists or to book a session with them: the alchemy of the impact will guide you towards a choice. When I chose my first therapist, I suddenly knew that he was appropriate for me, since the first session.

It is about gut feelings.

3. Therapy is not about performing

I believe that is fundamental to know that your therapist does not need the perfect client, he/she needs You. Many people go to therapy as it were a job interview, actually it is not. Therapy is about being and feeling emotions, thoughts, memories. Actively trying to perform for your therapist is not going to make the process satisfactory for yourself. It is important to keep your pace as well, there is no need to rush. Time will come when you feel able to be open to your therapist and show what is going on for you.

4. Therapy is a flow

I like to think to the therapy as a wave, with ups and downs. Not every session will make you think “Wow!”, some might feel quite mundane or flat if not openly frustrating. It is part of the process, sometimes you just have to trust it. That said, it is a good idea to tell this to your therapist because at times we need to be (or feel) stuck before proceeding.

I personally find very useful when stuckness or frustration is shared.

5. Therapy is all about You…

It is a common experience to think about a problem focusing on others. What others have done, have thought, have provoked and so on. When you are in therapy, it is important to focus on your role and acknowledge what the others may have done/thought/provoked. Even if you genuinely are the victim of a situation, you are going to therapy to put some light on the effect that the situation still has on you.

6. ..and nothing about You!

I firmly believe that therapy is co-created between the Therapist and the Client. That means that, again, the interaction happening in the consulting room will certainly be different from the interaction between you and another person. The ownership, or the weight, of the process is not only on your shoulder or on your therapist’s! This might sound odd, but it is definitely relieving and empowering at the end.

7. Therapy is not telling you the answers

Some people get to therapy thinking of finding somebody able to solve their problems while sitting in front of this person carefully listening. While I do respect this wish and desire, the reality here is that this is not going to happen. Therapy is about strengthening your ability to take decision that are good for you, balanced and explored and eventually to make hypothesis together. A therapist does not tell you what to act/think/believe.

8. Therapy may touch uncomfortable topics

Sex, Betrayal, Particular Habits or Behaviours are only some of the topics we all are ashamed of or find difficult to speak about. The number of clients reluctant to speak about those topics is high, being shy or doubtful to bring those subjects in the room is normal but it is important to address such topics because they might be the reason why you feel how you feel.

9. Therapy sees some backwards slides

Regardless of the reason why you are in therapy, sliding towards old strategies or behaviours is common, there will be no judgement for that. I believe that the reason why a client goes back to old strategies is because they do work, even if the outcome might be the reason why the therapy started. Being open when this happens can only help the therapy go forward, even if it might feel awkwardly difficult to bring in.

10 Therapy is not being self-indulgent or selfish

You deserve happiness. There is nothing more to say than this. Taking care of yourself is important and there is no indulgence in engaging with therapy. Selfishness is a complete different pair of hands, is about lacking consideration for the others and gain something out of this. Self-care is about being fully available for yourself and healthy. Happiness is not only for the few or the special, is for everybody. Everyone has done something regretful, or hurt somebody intentionally/unintentionally along the way: that does not prevent you from being happy.

11. Therapy costs money

Therapy overall costs money, there is nothing to keep hidden about it. One important part of this truth is that the level of attention/care you receive is not related to the money you pay. You probably want somebody who is qualified and trustworthy, that is exactly why the therapist you choose has to be right for you. It is pointless to choose a therapist basing your choice on how much he/she charges. Money are a very important part of the therapy itself, they probably are the stitching that binds us together for the length of the therapy. What they are not, is certainly the measure of the level of care you will receive. As therapist, I do this profession because I care about people and I hope they achieve an happier life.

I hope those points will help you in choosing what is right for you, and possibly to take the decision to start your journey. I would like to speak more with you about those points, if you feel like saying something please add your thoughts in the comments below!