Close menu

Complex and Severe Mental Health

Complex & Severe Mental Health

Specialist psychological therapy in collaboration with psychiatry.

Important: For complex presentations — particularly psychotic-spectrum and bipolar disorders — I work
alongside psychiatric care. In many cases, ongoing psychiatric involvement and prescribed medication
are essential prerequisites for working with me.

With your written consent, I liaise with your psychiatrist/GP where clinically appropriate to support safe, stabilising work.

 

A steadier kind of therapeutic space

Some mental health difficulties require a different kind of therapy — one that is slower, more structured, and
deeply attentive to safety, stability, and containment.

I offer specialist psychological therapy for adults living with complex and severe mental health conditions,
grounded in clinical rigour, relational depth, and clear ethical boundaries. This is not general counselling. It is careful,
collaborative work designed for people whose inner worlds have been shaped by intensity, disruption, or long periods of psychological strain.

Who this work is for

This service is for adults experiencing complex, enduring, or high-impact mental health conditions, including:

Complex trauma

Complex PTSD and developmental trauma, including longstanding relational or attachment injuries.

Dissociative difficulties

Depersonalisation, derealisation, dissociation, and trauma-related fragmentation.

Bipolar spectrum

Bipolar I, Bipolar II, and cyclothymia, with careful attention to stability and pacing.

Mood instability

Mood dysregulation with significant functional impact and a need for structured psychological support.

Trauma with complexity

Trauma complicated by psychosis, mood episodes, dissociation, or severe anxiety.

Many people seeking this kind of therapy are reflective and motivated, yet have found standard therapy models insufficient — or, at times, destabilising.

A collaborative model of care

For complex and severe presentations, psychotherapy must never sit in isolation. Where appropriate, I work in collaboration with
psychiatrists, GPs, and other professionals, with your written consent.

  • Collaborative care supports safety, continuity, and clinical coherence.
  • For bipolar and psychotic-spectrum conditions, psychiatric involvement is often essential.
  • Therapy is offered as an adjunct to medical treatment — never as a replacement.

These boundaries are not about restriction; they are about ethical practice, stability, and protecting the work from becoming overwhelming.

How therapy can help

When the right structures are in place, therapy can support:

  • Greater emotional and mood stability
  • Understanding your internal world without becoming overwhelmed by it
  • Reduced shame, fear, and self-blame around diagnosis
  • Strengthening identity, continuity, and a sense of self over time
  • Trauma processing that is paced and contained
  • Improved relationships, communication, and trust
  • Recognising early warning signs and patterns of vulnerability
  • Building a life that feels more liveable, grounded, and coherent

The emphasis is not on “fixing” a person, but on supporting stability, meaning, and agency within the realities of their condition.

Therapeutic approach

My work is informed by:

Psychodynamic & attachment-based therapy
Trauma-informed stabilisation
Careful use of EMDR where appropriate
Nervous-system regulation & pacing
Containment & reality-testing

This is thoughtful, relational work — not techniques applied without context. In complex presentations, knowing what not to do is as important as knowing what to offer.

What this work is not

  • Not crisis or emergency care
  • Not a substitute for psychiatric treatment
  • Not suitable during acute psychosis, mania, or severe instability
  • Not a one-size-fits-all model

Clarity protects both the client and the therapeutic work itself.

Referrals and suitability

I accept referrals from psychiatrists, GPs, and other clinicians, as well as self-referrals where appropriate care is already in place.
Before beginning therapy, we will consider current stability, psychiatric involvement, medication status (where relevant), and whether this approach is clinically suitable and safe.

Enquiry

If you are unsure whether this service is right for you, you are welcome to get in touch. With your written consent, I can liaise directly with your psychiatrist/GP to clarify suitability.


Contact Comfort Shields Practice

Explore specific areas of work

You may wish to read more about:

A final note

Complex mental health difficulties deserve depth, respect, and careful thinking — not rushed solutions or false reassurance.
My role is to offer a therapeutic relationship that is steady enough to meet complexity, and boundaried enough to remain safe.