Category Archives: CBT

Guest post: What can the UK government do to cultivate good mental health? by Ann Heathcote at Worsley centre of Psychotherapy

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According to statistics revealed by mentalhealth.org.uk 65% of people in the UK have experienced a mental health problem in their lives at one time or another. What’s more revealing is that just a mere 13% of us say that we live with high levels of good mental health in our daily lives.

These stats suggest there is much to do to improve the state of our mental wellbeing, but to turn things around will require help from the powers that be, namely Government.

But is the UK Government doing enough to ensure that current and future societies have good mental health. And if you believe they could more, what action can be taken to fix this prevailing problem?

We reached out to some of the leading voices on mental health issues to get their opinion.

See full article at https://theworsleycentre.com/what-can-the-uk-government-do-to-cultivate-good-mental-health/

 

Ann Heathcote opened The Worsley Centre for Psychotherapy and Counselling in 2001, as a centre for the provision of professional psychotherapeutic services.

The Worsley Centre is a warm and welcoming environment for people wishing to undertake counselling and psychotherapy. The practitioners at the Centre care deeply about each individual’s mental health and well-being. They all share a passion for providing high quality therapeutic services.

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Smiling through the rain: Early morning anxiety and life with bipolar.

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Its been almost a week or so since I have written a blog and thats because life has been hard lately. Due to my early morning panic attacks and increased anxiety about leaving the house at that time, I couldn’t get in to work. Luckily, I can do online work on home doing social media and writing, so that is one major plus point. However, currently I am seeking extra support about my morning anxiety and fears.

I have lived with my anxiety disorder for most of my life- it comes in times of stress or times when I get triggered by something I can’t always explain- having to get up early and achieve, having to show up in the morning despite feeling so quivery and vulnerable, having to feel like I can cope- when inside I feel so scared. For reasons I can’t always pinpoint.

I have tried so many therapies and I would say with me, I have to use things in combination like breathing techniques, meditation, distraction, colouring and exposure therapy. However, now I would very much like  to find a psychological therapy that works for me. I have had 3 lots of cognitive behavioural therapy, which for me doesn’t seem to take away the fear. It is helpful for understanding limiting beliefs  like ‘I’m not good enough’  or ‘ I can’t do this, I will mess up’  and then understand where these fears come from and how they impact on life.

Briefly I will explain that I believe these limiting beliefs have come about because of trauma. The trauma of being hospitalised a few years ago for my bipolar disorder and having to learn to live life and get back to normality again despite disruption. The trauma of not feeling good enough, not feeling like I can live up to my perfectionist standards- not wanting to let people in my life down or me down . Feeling like I have to really achieve and be good at everything I do, because this belief has helped me fight, fight, fight for life and everything in it.

I, like many others with mental health issues, am hard on myself. I have a little voice though that won’t be tamed and is constantly pushing me to achieve and help people, help myself, be better. This is because I know the pain of setback. I know the pain of fear. and I know the pain of being confined to a hospital ward. So when I am well- nothing will stop me. The panic attacks may stop part of my life, but they won’t stop me from telling my story and reaching others. They wont stop me from being able to live and being able to touch peoples hearts through my writing (this is what I strive for).

Right now, I am dreaming about so much and hoping to put these dreams into reality. I will get therapy and I will get better with much effort and time. I will not let this keep me down- because I, like so many with my conditions, am a fighter and I will make sure that I live life to the full.

And part of this therapy is writing on my blog and being authentic, real and honest. And being blessed and thankful for my medical team, family, boyfriend, friends and support networks. Support is everything and I am so lucky.

Thanks for reading <3.

Nobody’s Perfect: An Update on life with Anxiety

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I have put off writing for several weeks just because its so hard to make sense of everything going on in my brain, in terms of my anxiety disorder.

I have had so many good things in the past few weeks but I am also battling anxiety around work. I love my job but past events relating to employment have made me afraid subconsciously. I very much need to unpack these fears with a therapist- I have been on the therapy waiting list for a year and a half. In a few weeks, I will be seeing my new psychiatrist (roughly the 12th/13th one in 13 years due to high staff turnaround!)  and I hope that he will escalate my therapy. I desperately need help with this as I get morning panic attacks around these fears. Despite using self help methods like meditation, these fears can be all consuming and stop me from going into work.

It is incredibly difficult for me to write about this because its so personal and because I love what I do. However, I have been struggling and I hope by writing that yes, I do get panic attacks about my fears, I can also make others feel less alone.

I did get some respite from these fears and work have been very supportive of me. I was able to go with my friend for a week on holiday to Madeira, a Portugese island off the main land near North Africa. Its a beautiful island, filled with terracotta roofed houses, turquoise seas, dolphins, whales and  turtles, friendly people, bright sunshine and palm trees. We went on a boat trip and got to see some spotted dolphins and relaxed in and by our hotel swimming pools. Not to mention the love for Cristiano Ronaldo on the island, as he is from there and the airport is named after him! It was a really restful and fun trip. I wasn’t anxious all week- as it seems to get triggered by specific fears and situations.

I just hope to get back to full health again and get some extra support around the fears that are fuelling my panic.

I tend to beat myself up about having an anxiety disorder and feeling ‘incapable’ of doing certain things. I am learning self love and to be calmer and to just see my anxiety as a hurdle to be overcome. I may be a perfectionist who hates letting others down
– but I am learning, like the Jessie J song, that Nobodys Perfect. 

Anxiety Gremlins: Panic, Exhaustion and everything in between

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This post is probably the most honest one I have written (and as you all know I am pretty open about my mental health struggles).

I am completely and utterly exhausted, tired and fed up. I have been experiencing daily morning panic for 5 days, where leaving the house to go to work feels incredibly overwhelming.

This has happened to me before and I have got through it with exposure therapy and excellent support networks and medical team. I am incredibly lucky also that I work with supportive colleagues/ teams in my job, who go above and beyond to make sure I can be OK.

I am vulnerable to certain life stressors which can trigger my panic attacks and in particular morning anxiety. Due to the adrenaline and cortisol that is triggered during the panic, I feel like I have run a marathon but equally don’t want to sleep too much during the day so I am at home resting, recovering and recuperating. This may mean watching Love Island religiously, but I digress….

I feel like I am constantly on an emotional tread mill. The anxiety gremlins keep rearing their heads. This week has been particularly challenging due to the fact I have had panic attacks every morning. For me, my attacks are more emotional- I don’t tend to get palpitations or hyperventilate, I freeze like in fight or flight and then avoid. The avoidance temporarily stops symptoms but….

Avoidance is the worst thing you can do when you have an anxiety disorder. The worst. And yet we do it to feel ‘safe’ when really the feared event or trigger is not fearful at all.

I know that with support, I can get through this and feel much better. I have been recommended to the charity No Panic by a friend and yesterday I did the Yoga Nidra relxation meditation which calms the mind and body . I will keep trying to conquer the fears triggering my panic disorder- I have tried so much in the past but will have to keep going. I have been on the NHS waiting list for therapy for over a year. So I am having to do a lot of self help methods in the mean time.

Thank you everyone who has offered advice and support. Off to rest but will be back soon.

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Guest post by Karen: Being a Mental Health Professional with Anxiety, my Recovery

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Working in an outpatients’ mental health service in the NHS I was well-placed to recognise the signs and symptoms of a mental health problem. I have seen most ends of the spectrum from working in a secure men’s forensic unit, treating people experiencing psychosis in a clinic and in their homes, to treating outpatients with mild to moderate depression and anxiety. Yet none of this prepared me for my own mental health crisis that crept up on me suddenly and unexpectedly last year.

I have experienced anxiety in my life on many occasions before. I developed a fear of panicking and losing control going on the tube and was starting to avoid taking tubes and trains and places I felt I could not escape from easily. Later on I realised this was panic and agoraphobia and since I was considering dropping out of my Masters degree because it involved travelling long routes by tube, I knew I had to get some help. I had a course of CBT privately using graded exposure therapy which I had to get on board with and be committed to, and was incredibly effective for me. My CBT therapist was a real lifeline for me and we had an effective rapport which really helped.

I have since moved out of London and abroad. In September last year I started a number of new part-time teaching roles (not in mental health) in my relatively new European city. I was really worried about my ability to speak the language and to be able to communicate if there was a problem. In fact, I had pretty much spent my entire summer holiday dreading, worrying and catastrophising about all the things that could go wrong, and didn’t really tell anyone exactly how I was feeling.

I started in one of my jobs and it seemed to be going just fine the first week. I did experience a lot of worry after each class and before the next one. I was really concerned about how other people would perceive and judge me, particularly as I was not yet fluent in the language and could not understand 100%. I continued to be anxious about how other people thought I was doing my job for the next few days and had consistently negative thoughts that would not go away which were concerning as they seemed to upset me more and more. I remember that on the last day of that first week, I had been introduced to my new colleague, a really lovely lady who seemed really helpful. She was really experienced and obviously had a lot of knowledge and I started to feel inadequate in that moment. That was the moment everything spiralled out of control.

I went home and over the weekend I experienced constant racing thoughts of things going wrong and worst case scenarios. My husband and I were watching TV in the evening and I just could not focus on anything as my mind was racing so much. What surprised me the most was how physically I felt the anxiety this time and how different it was to any anxiety I had before this. I felt hot and cold every few minutes, had the sweats and could not sleep for days. I could not seem to regulate my emotions and rationalise them. I retreated to bed to warm up and calm down and called my mum for moral support. I lost my appetite and could physically not put anything in my mouth apart from forcing some sugar down me.

This pattern continued the closer it came to Monday. I found it really hard to get out of bed – I was heavy, anxious and tired due to lack of sleep. It was hard to sit up straight and I forced myself to have breakfast. I have never felt before the way I felt that day. I was inconsolably crying, paralysed with terror, and curled up on the sofa. I called in sick to work and spent the best part of the entire day on the phone to my parents who flew out the next day to be with me. All of this was entirely alien to my husband. He knew I worked in mental health but I guess I never realised that he totally didn’t understand what I did and what mental health looks like. He had no idea what was going on with me and had to learn how to support me.

I am really lucky to have found a supportive and really competent GP when it comes to managing mental health. I wanted to be put on a course of medication as I know that medication is a key part of the treatment equation and the SSRIs I am on have helped tremendously. My GP also gave me a temporary course of benzodiazepine very closely monitored by her to help me with the initial stage of going to work, coping with the anxiety and helping me sleep initially.

All in all, this was a really acute depressive/anxious episode and I did go back to work the following week with a LOT of positive self-talk, support from husband and family, and a chill pill. My recovery was gradual and I guess I realised that we are all vulnerable at one time or another. My parents have both experienced anxiety and depression over their lives and I know that having a depressive episode makes it more likely that we will experience further episodes.

Recovery means making your mind your priority and this is what I’ve tried to do. I have regular follow-ups with the GP every few weeks as I’m still taking medication. I am concerned about how coming off the medication might affect me but I have a good relationship with my doctor and trust that she will manage that process with me in the next few months. When I’m feeling anxious and restless I know I need to up my exercise to channel my adrenaline elsewhere. I try to facetime friends and family more often and say what I’m feeling more. My friends have been so supportive and didn’t judge or change their behaviour towards me when I told them- I found it really hard to tell them though. Having a good night’s sleep helps too- going to bed and waking up at regular times. I have also found Acceptance and Commitment Therapy (ACT) self- help reading to be extremely helpful too and highly recommend “The Happiness Trap” by Russ Harris- a refreshingly easy way of managing difficult emotions and learning to live with them.

The biggest piece of advice I can give anyone who is struggling with negative thoughts, depression, anxiety, stress, is to tell the people closest to you what helps you. Sometimes it’s the fact that our family’s, partners, friends don’t know what helps or what to say which causes more stress or potential conflict. Tell them what you would like them to do or say to you when you are feeling a certain way. I told my husband that every time I start to feel anxious, inadequate and catastrophising about my work, to remind me of how much enjoyment I have had at work and the positive things I say when I get home from work.

I don’t believe that a cardiologist should have experienced a heart attack to make them more capable of treating a patient effectively, but as a Mental Health Professional, I do have that bit more compassion and understanding of the vulnerability that we all have, no matter which chair you are sitting in.

 

 

Guest Post: The Efficacy of Online Cognitive Behavioural Therapy- CBT by Dr Stacey Leibowitz- Levy

We are delighted to have Dr Stacey Leibowitz-Levy, psychologist writing about Cognitive Behavioural Therapy for us. As with any therapeutic practice, it is very much individual as to whether it will work for you and CBT will not work for everyone- but has been proven to work for many. Here Dr Leibowitz-Levy explains how it can work online.                        

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Online counselling is a growing field with more and more people turning to the internet to seek out counselling help. Counselling services offered online incorporate the range of therapeutic approaches that have been developed within the field of psychology. Approaches to understanding mental ill health and treatment include therapeutic approaches such as logo therapy, psychodynamic therapy, systemic therapy, psychodynamic therapy and Cognitive Behavioral Therapy (CBT). How do these therapeutic modalities translate to the online environment? This article will address the compatibility of CBT in particular as an online counselling approach.

CBT is a widely-utilised mode of therapy that focuses on an awareness of the relationship between thoughts, feelings and behaviour. The aim of CBT is to address difficulties through modifying distorted thoughts, unhelpful behaviour and unpleasant emotions. In order to achieve this end, the client works collaboratively with the therapist in building awareness and understanding of his/her condition, and an accompanying skill set for evaluating and changing distorted beliefs (as well as modifying dysfunctional behavior). The therapist develops clear objectives and a treatment plan that requires active participation from the client during sessions, and follows through on homework assignments between sessions.

This form of therapy is characterized by a structured, time limited and outcome focused approach to managing mental health challenges. Often CBT is focused on a specific issue such as anxiety or managing depressive thoughts and, as such, many CBT interventions are available in a protocol format. CBT offers a delineated and clearly defined intervention that is largely directed by a clearly defined process and structure. This is in contrast to many other therapeutic approaches that have less defined parameters and take their cue on a session to session basis from the client.

The format and approach of CBT lends itself to an online format in that the structure and process are not only defined and constrained by the relationship between therapist and client but are also defined by a clearly delineated therapeutic procedure. This procedure offers a framework within which to deliver support which can easily be translated to an online process. CBT follows a set format. It is driven by the imperative of building an understanding of the issues the client is experiencing and imparting a certain skill set to assist the client in managing his/her mental health issues. CBT is thus based on specific content and has a strong psychoeducational aspect, which means that delivery online can be located in tangible and clear cut content and outcomes for the client.

This also allows for versatility in the delivery of CBT online. While face to face time with a therapist may be desirable for some clients, the option of online delivery of psychoeducational as well as skills based elements in other formats also works well. For instance, the psychoeducational aspect could be communicated very effectively through a video delivery. CBT lends itself to the format of online courses where clients are guided through a process of identifying and understanding their particular issues and developing the skills to manage them. Interspersing this with face to face time or the opportunity to clarify or ask questions in a chat or e-mail format makes for a very effective online intervention.

While many of the issues addressed in CBT are personal to the client, the possibility of locating these issues within a more general format is very much part of the CBT approach. There is a set way of getting information from, and accessing and understanding the client’s experience, with the client having to act on this information between sessions. This more “scientific” process also makes for an approach that lends itself to an online format.

The efficacy of CBT as an online intervention is borne out by the number of sites specifically offering online CBT in a variety of formats (for some examples, see here and here). The online availability of this well researched and well-verified approach to managing mental health problems offers increased affordability, accessibility and greater choice for mental health consumers.

Dr. Stacey Leibowitz-Levy is a highly-experienced psychologist with a Master’s Degree in Clinical Psychology and a PhD in the area of stress and its relation to goals and emotion. Dr. Stacey has wide ranging skills and expertise in the areas of trauma, complex trauma, anxiety, stress and adjustment issues. Stacey enjoys spending time with her husband and children, being outdoors and doing yoga.