We are offering psychological therapy to work with a broad range of psychological conditions including:
- Depression and mood disorders
- Anxiety / worry
- Social anxiety
- Generalised Anxiety Disorder (GAD)
- Obsessive Compulsive Disorder (OCD)
- Specific phobias
- Post traumatic stress disorder (PTSD)
- Body Dysmorphic Disorder (BDD)
- Eating disorders
- Low self-esteem
- Relationship difficulties
- Sexual dysfunction
- Chronic fatigue syndrome / ME
Depression and mood disorders
Some people experience a low mood/depression, which can range from feeling like you have ‘gotten out of bed the wrong side’, to feeling so low in mood that you do not want to get up, go out, socialise or eat and in some cases feeling suicidal. The experience of low mood/depression may include symptoms such as negative thoughts about the self, others or the world and feelings such as depression, anxiety, guilt and anger. People may respond to the thoughts and feelings in a number of different ways including withdrawing from others and finding it harder to do everyday activities. Some people also report losing the enjoyment that they previously gained from activities/experiences in their lives, and experiencing sleep problems, disruptions in their appetite and a loss of libido. Psychological therapy such as cognitive behaviour therapy (CBT) has been found to an effective treatment for depression.
Some people experience fluctuations in their moods, ranging from low / depressed mood to more high and elevated moods. During these elevated mood states people may experience racing thoughts, feelings of elation, happiness and/or irritability. They may find that they get lots of tasks done, however this can be at a cost of them sleeping enough and/or eating enough. People may also find themselves taking more risks and spending more money during these elated periods. Psychological therapy can be used to help people make sense of these mood fluctuations by exploring what triggers the ups and downs in their mood and looking for strategies to manage their thoughts, feelings and behaviours following a trigger.
Stress, for example work and / or life stress
Life can be stressful for many different reasons, for example stress at work, parenting stress, juggling to get the balance right between work and home life demands. Stress can become problematic when our personal and emotional resources to cope with our situation are overwhelmed by the demands made on us by a particular event, situation or experience. Therapy can help people to work towards restoring the balance, whereby their personal and emotional coping resources are brought back into balance.
Anxiety / worry
Anxiety and worry can have a negative impact on our lives. The feeling of anxiety tends to be accompanied by anxious and worried thoughts, which can impact on what we do, for example attempting to avoid situations that make us anxious. Therapy, such as CBT can help people to manage their anxiety/worry by developing strategies to question anxious thoughts, and learning to change their behavioural responses to anxious thoughts / feelings. Therapy can also help people to gain a greater tolerance and acceptance of anxiety.
Social anxiety refers to the anxiety we feel in anticipation of social occasions and also during them. The anxiety relates to a fear of embarrassment and or humiliation. People who experience social anxiety often experience an image of how they perceive they will look to others in the social situation. People may experience social anxiety for a number of reasons, including fear of blushing, fearing that they have nothing of interest to say, worrying that they will shake or embarrass themselves. Social anxiety can mean that people will avoid social situations, or engage in certain behaviours whilst in the situation to help them through, for example drinking alcohol to gain social confidence, rushing to get the event over, not talking to people at a party. These behaviours can prevent the person from finding out that they can tolerate the situation, and also that perhaps what they fear either does not happen or is not as bad as they thought. Following social situations socially anxious people may reflect on their experience of the social situation, which can subsequently add to their anxiety and fear of entering the next social situation. Cognitive behaviour therapy has been found to be helpful in treating social anxiety.
Generalised Anxiety Disorder (GAD)
Generalised anxiety disorder refers to when people experience chronic and high levels of anxiety relating to a number of events or experiences. People often experience the thought ‘what if…..’, which leads them to worry about upcoming events. The levels of anxiety experienced can interfere with the individual’s ability to problem solve their worries, and ultimately they can lose confidence in their ability to problem solve which then increases their anxiety. CBT has been shown to be effective in helping people with GAD to stop avoiding their underlying fears, learn to tolerate some uncertainty, question anxious and worrying thoughts and develop techniques to break the worrying cycle.
Obsessive Compulsive Disorder (OCD)
Obsessive compulsive disorder (OCD) refers to the development of anxiety provoking thoughts or images (obsessions), for example ‘did I shut the door?’. These thoughts are normal thoughts that we all have, however for individuals with OCD the meaning behind the thought is meaningful and powerful. For example, individuals with OCD may believe that they have a responsibility to stop something bad happening. In order to cope with these powerful obsession, the individual will engage in a behaviour to neutralise the anxiety surrounding their thought (compulsion), for example checking repeatedly whether the door is shut. The types of obsession often fall into one of four categories, contamination fears that often relate to cleaning compulsions; a fear of being responsible for something harmful occurring, such as leaving the iron on and fearing that the house may catch fire, which relates to checking compulsions; a need for perfection and orderliness, which relates to having to have objects in a certain way; and a fear of losing control of the self, for example someone may have a thought such as ‘what if I shout out loudly during this film’, which can lead to behaviours that attempt to control thinking. CBT has been found to be an effective treatment for OCD. Therapy often involves the individual exposing themselves to their feared situation and not engaging in their compulsion, in order to find out whether there is any evidence for their feared outcome.
A specific phobia develops when an individual experiences a heightened fear about a specific object, such as spiders. The phobia can develop following a frightening experience involving the object, for example a phobia of dogs may develop after a person gets bitten by a dog. The phobic individual will tend to avoid the phobic object which tends to increase the danger associated with the object and reduce their confidence in coping with the situation. Some people also experience a fear of blood and needles, which is referred to as blood injury phobia. CBT has been found to be an effective treatment for specific phobias.
Post traumatic stress disorder (PTSD)
People can experience post traumatic stress disorder following an event in which they believed that they were going to experience significant harm and / or death, for example following a road traffic accident, domestic violence, rape. This can result in a range of symptoms, including high anxiety and sometimes feelings of guilt. People can also experience memories and ‘life like’ flashbacks of the event, whereby they re-live the event each time a flashback is triggered. People can also experience nightmares relating the event. This can result in people avoiding experiences that may trigger memories and flashbacks of the trauma. CBT has been evidenced to be an effective treatment for PTSD, and is based on the premise that because the memories of the traumatic event are so painful, people understandably avoid thinking about it. However, this can lead to the memories getting frozen in time, because the brain has not had a chance to process it. Therapists work with the individual to help them process the painful memories by thinking/talking/writing about the trauma and also to challenge any negative beliefs that may have arisen from the trauma.
When someone experiences a panic attack they experience an abrupt increase in their anxiety levels, often accompanied by anxious and racing thoughts, and physical sensations such as increased heart rate, sweating, feeling nauseous and/or faint and feeling distanced from the situation. During this experience people tend to experience a catastrophic thought such as ‘I need to get out of this room otherwise I will faint’, and subsequently leave the situation. When a person leaves the situation the anxiety tends to subside. However, by leaving the situation people do not get to test whether what they fear will actually happen, and also to learn that what they are experiencing is anxiety. When an individual experiences multiple panic attacks then they can be diagnosed with panic disorder. Panic attacks can be triggered by thoughts and situations, but some people report that they attack ‘just came out of the blue’. For some individuals who experience panic attacks they can develop a fear of going outside (agoraphobia), in case they have a panic attack. CBT has been found to be an effective treatment for panic attacks, and tends to involve education regarding the effects of anxiety on the body, identifying triggers, testing the catastrophic thought and ultimately moving towards a less harmful understanding of the anxiety experience.
Body Dysmorphic Disorder (BDD)
Body dysmorphic disorder refers to an individual’s belief that one or many parts of their body does not look or feel right, for example their facial skin. This anxiety regarding the body part can lead to a number of behaviours including repeatedly checking the body area and looking in the mirror, researching reasons and solutions to the perceived problem, and asking for reassurance from others. These behaviours often serve to increase the individual’s anxiety and thoughts about their body part. Therapy using the CBT approach involves helping the individual to understand the role that their behaviours have on increasing their distress and discontent with their body part, and subsequently dropping the behaviours. Body image thoughts and beliefs can also be challenged. Some individuals benefit from mirror retraining, where they re-learn how to look in a mirror in order to promote them seeing themselves as a whole rather than fragmented parts. Therapy may involve working with close family members who may be involved in reassurance giving.
People can experience a number of eating disorders including anorexia nervosa, bulimia nervosa, binge eating disorder, eating disorder not otherwise specified (EDNOS) and obesity. According to the diagnostic and statistical manual of mental disorders, fourth edition (DSM-IV) the eating disorders have been described as follows:
- Anorexia nervosa is diagnosed when an individual’s body weight is classified as being underweight and their beliefs place too much importance or value on their body weight. People with anorexia nervosa are also likely to experience disturbances in their body image, for example when they look in the mirror they perceive themselves as being larger than other people would perceive them. Men and women can experience a loss of libido. Women will have stopped menstruating due to their low body weight. Individuals with anorexia nervosa have been divided into those that restrict their food intake and those that tend to overeat (binge) and then overcompensate for this eating by purging themselves, for example by vomiting or excessively exercising.
- Bulimia nervosa refers to people that experience a similar over concern with their weight and body shape, however they differ from people with anorexia nervosa, because they tend to binge (eating large amounts of food in a set time period accompanied by feelings of being out of control) and then purge to rid themselves of the food, for example vomiting, using laxatives, not eating or excessively exercising.
- Binge eating disorder describes people who tend to binge eat without engaging in any strategies to compensate for the food they have eaten.
- Eating disorder not otherwise specified refers to people who meet the criteria for an eating disorder, but do not fully fit the criteria for either anorexia nervosa or bulimia nervosa.
- Obesity refers to people who are medically overweight. Obesity may result from psychological and/or other reasons.
CBT and family therapy have been the most researched interventions for eating disorders. CBT has been found to be effective in the treatment of bulimia nervosa and binge eating disorder. In severe cases of eating disorders inpatient treatment may be required.
People tend to feel guilty when they perceive themselves as being somehow responsible or to blame for an event/situation. People may believe that they have done something wrong and feel remorse for this. Psychological therapy, such as CBT can help people to explore the origins of their feelings of guilt, and what maintains the guilt. CBT can be used to question thoughts relating to the feelings of guilt.
Low self esteem or poor self belief can exert an ongoing undermining influence on an individual’s life. Low self esteem often accompanies many other mental health difficulties, such as depression, social anxiety, eating disorders and body dysmorphic disorder. Therapy such as CBT can help an individual to identify their negative beliefs that undermine their sense of self worth, and subsequently look for evidence against these beliefs and accompanying negative thoughts and feelings.
Anger is a ‘normal’ human emotion, however sometimes people can feel out of control with the amount of anger or rage that they feel, and sometimes get into trouble because they act on their anger, for example hitting someone, driving recklessly or smashing an object. Therapy such as CBT can help people to manage high levels of anger by looking at their anger response in terms of thoughts, feelings, physical sensations and behaviours, and working out at what point in an individual’s anger continuum they can learn to reduce their anger levels to avoid it becoming destructive. Therapy can also help people to understand what types of situation trigger their anger and why.
Sleep problems can have a debilitating impact on a person’s life, particularly in terms of their functioning, fatigue levels and mood. Sleep difficulties can occur within the context of a mental health condition, such as depression, anxiety disorders and trauma. Therapy can help people to learn about sleep hygiene (how to promote the best sleeping conditions). Through therapy the individual may gradually re-condition their body into sleeping in the ‘normal’ sleep/wake cycle, and also address any factors such as worries/anxieties/nightmares that may be contributing to their disrupted sleep.
After losing a significant person through death, it is understandable to feel a myriad of emotions such as sadness, anger, anxiety and many other emotions. Time can help people to work through their grief reaction. However, for some people the grieving process can become chronic, and in these cases it may be useful to use psychological therapy to explore what is maintaining the grief and also explore ways of remembering that person but also moving forward in life. For some people who had a difficult relationship with the person who died, they can experience a ‘complex’ grief reaction, due to factors such as never reaching a resolution of conflict with that person, or telling them how they really felt. Therapy can help the individual to explore the complexities of their grief reaction.
Psychological therapy, using either a CBT framework or a systemic framework can help couples work through relationship difficulties. Therapy can provide a neutral environment for couples to reflect on their difficulties and work towards a joint resolution.
Sexual dysfunction refers to difficulties relating to desire, arousal and / or orgasm experienced by an individual and / or a couple. Anxiety surrounding the particular difficulty can serve to maintain or exacerbate the difficulty. Therapy can help people to identify their anxieties and then learn ways of managing their anxiety levels to promote enjoyable sexual relations. Therapy can also promote openness within couples in order for them to explore ways to promote their sexual relationship.
Chronic fatigue syndrome / ME
Individuals with chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME), experience pervasive tiredness following activity. This tiredness can be experienced as both physical tiredness and also mental tiredness. This tiredness does not seem to be improved by sleep or rest. The fatigue can have a detrimental impact on the person’s every day functioning. Other symptoms include muscle pain, memory problems, depression, insomnia, stomach pain and diarrhoea. Psychological therapy such as CBT can help individuals with CFS/ME to come to terms with their diagnosis, manage the emotional impact of the condition, question negative thoughts that may be maintaining emotional difficulties and learn to pace activity.