Why People Work Rick Cox Psychodynamic Psychotherapist MBACP (Accred.)
I work with adults across the UK who feel anxious, overwhelmed, ashamed, or stuck in repeating emotional patterns. Many of the people who come to me have tried therapy before, or have spent years coping, understanding, and managing, but not really changing.
This page explains how I work, what makes this approach different, and why it often helps when other forms of therapy haven’t gone far enough.
A new way of working shaped by experience
I’ve completed over 4,000 hours of online clinical work with adults across the UK. Over time, certain core difficulties appear again and again, even though people’s lives look very different on the surface.
They usually come down to:
Fear of your own feelings
Fear of closeness or dependency
Fear of yourself and your inner critic
Therapy is where we slow this system down enough to see how it actually works. There is no pressure to perform and no requirement to have answers. The work is about developing the capacity to look at what has been running your emotional life for a long time.
What people often bring to therapy
People usually reach out when something can’t stay the same:
Emotional avoidance. Feelings rise, are pushed down, and anxiety takes their place.
Relationship patterns. Getting close, then pulling away, or losing yourself in others.
A harsh inner critic. Especially when you try to change or take emotional risks.
Chronic shame. A quiet sense that something is wrong with you.
Feeling stuck. Repeating the same emotional loop, knowing it hurts, unable to stop.
Most people don’t arrive with a clear story. They just know something isn’t right.
How I work
I work in a psychodynamic and ISTDP-informed way. That means we don’t only talk about your history or your problems. We pay close attention to what is happening in real time.
Together, we notice:
Small shifts in your body
Moments of tightening, pulling away, or going blank
Thoughts that turn sharp or defensive
The impulse to change the subject or move away from something
Feelings that rise and then collapse
This is active, focused work. But it always moves at the pace your nervous system can tolerate.
Why this approach often works when others haven’t
Many people come to me after trying CBT, counselling, or years of coping strategies.
Those approaches can be helpful. But sometimes they don’t reach the level where change actually sticks.
This work goes deeper:
We work with the emotional truth under the symptoms.
We work directly with the anxiety that blocks feeling.
We work with the patterns that keep repeating, as they appear in real time.
The aim is not to make you feel better quickly. The aim is to help your emotional system reorganise so that change becomes possible and sustainable.
What working with me often feels like
People often say things like:
“I said things I didn’t plan to say.”
“It was uncomfortable, but in a good way.”
“I didn’t realise how much I was holding.”
“I finally understood why I react the way I do.”
“I actually felt something.”
Therapy becomes a place where what has been avoided can finally appear, without becoming overwhelming.
Who I work best with
People who:
Know they are avoiding something important
Feel deeply but lose access to those feelings when it matters
Function well outwardly but feel constrained or stuck inside
Carry old emotional injuries that still shape the present
Want their inner world to make more sense
You don’t need to arrive prepared, confident, or articulate. You just need a willingness to look at what is actually happening in you, with support.
What you can expect if we work together
Clarity. A grounded understanding of your emotional patterns.
Movement. Feelings that were blocked begin to become accessible.
Strength. Less avoidance, more choice.
A more honest relationship with yourself. Less self-attack, more emotional reality.
This is not quick work. But it is real.
People tend to stay
One pattern I’ve noticed across several years and several thousand sessions is that people usually don’t drift in and out of this work. Once we begin, the therapy tends to become something that can be stayed with, even when it becomes emotionally demanding.
I pay a lot of attention to the frame, the alliance, and to helping therapy become something stable enough to work inside rather than something that constantly restarts.
My Experience at a Glance
8+ years clinical experience
National media contributor (Guardian, HuffPost, Therapy Today)
BetterHelp UK Brand Ambassador
Intensive focus on anxiety, shame, avoidance, and emotional complexity
Training grounded in psychodynamic and ISTDP-influenced approaches
Alongside clinical practice, I publish short clinical guides for therapists working with depth-oriented psychotherapy.
Book a Consultation
Ready to have a different conversation?…
Taking the first step can feel impossible, but you don’t have to do it alone. If what you’ve read resonates with your life, reach out. Together, we can start to take a good honest look at what’s been holding you back and begin the process of change.
Fees £65 per 50-minute online session
Flexible AM/PM appointments
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