Tag Archives: Cognitive behavioral therapy

Perception vs reality


perception photo

Perception vs reality

Think of your perception of reality as your ‘map’. Think of reality as the ‘territory’. Perception vs reality is an important factor in how we live our lives and how successful we are at picking up on what is really going on. Over the years I have listened to many people’s stories, especially all the ways things can go wrong.Our parents teach us what they have learned. Along with this information, comes biases, prejudices and faulty assumptions which leads to our maps not quite fitting the territory. Our perceptions are ultimately distorted and stop fitting reality and this is where many problems come in.

We look for evidence that confirm our beliefs about the world and this, in turn, reinforces our perceptions and distorts what we see. I have seen many clients whose map is so far removed from the territory that they no longer actively engage with the world in a productive way that makes sense. People with severe anxiety and depression often have distorted maps and this causes them to only focus on certain negative aspects of reality in order to make sense of their thoughts and perceptions.

When it comes to perception vs reality, always look for the evidence in reality that supports your thinking/perceptions. This is one way to avoid upsetting and unhelpful thinking from getting the better of us. Cognitive behavioural therapy regularly refers to unhelpful thinking styles that tend to add to our stress. Thoughts such as: black and white (all or nothing) thinking, personalising (blaming ourselves for things that have nothing to do with us), catastrophising, emotional reasoning (I feel upset therefore something MUST be wrong), mind reading (thinking we know what others are thinking) and so on.

We have a lot of flexibility in the thoughts we want to choose to make sense of reality. Make sure you choose these thoughts wisely – ones that are reasonable, based on evidence as much as possible (rather than assumptions) and provide you with positive feelings.

Mandy X

PS. In times of distress, check what you have been telling yourself (your perceptions and thoughts of the reality) and always ask yourself “What can I tell myself that will make me feel better about this situation?” Always look for alternative ways to look at something – they are always there.

The cause of anxiety


anxious photo

The cause of anxiety

In cognitive behavioural therapy, we refer to the anxiety equation. The anxiety equation shows the cause of anxiety.

Overestimation of the threat

____________________________________  =  Anxiety

Underestimation of ability to cope

Anxiety is always caused by our overestimation of the perceived threat and our underestimation of our ability to cope or handle the situation.

With regard to overestimating the threat – think about a time when you have anticipated an event and got yourself all worked up over it. Then  when you have actually experienced the dreaded event, you have found that it wasn’t half as bad as you expected it to be. Sound familiar?? This is part of the reason why we feel so anxious.

The other part is that we often underestimate our ability to cope. We tell ourselves we won’t be able to do it or that if the feared thing does happen, we will have a panic attack or not be able to manage it. We talk to ourselves in a fearful way that adds to our sense of dread. What we then do is try to avoid the event (which is the worst thing to do) or we find ways that we feel will help us cope by employing “safety behaviours”. Safety behaviours are things that we do that help us to cope temporarily in a feared or stressful situation. For some, it may be carrying a bottle of water or looking at our mobile phone (say for example in a situation where we feel anxious socially, in the company of others) or it could be complete avoidance. The problem is that when we avoid something we fear, the fear grows in our mind and we never test out our beliefs. When we face our fears, we often realise that we cope far better than we thought we would and this helps us to grow in confidence.

Even of the feared event doesn’t go that well, we teach ourselves that we still get through it, that we are still standing at the end of it and in this way we chip away at the fearful beliefs.

So, keep facing your fears. Keep repeating this and the more you face the feared situation, the easier it becomes and the less you will fear it. Start with baby steps if need be. For example, if you truly fear walking in to a room full of strangers ( a 10 out of 10 rating for anxiety, 0 = no anxiety, 10 = most anxiety), start with a 1 or 2 out of 10 anxiety rating. For example, perhaps start out by entering a room with one friend in it, then a few friends in it (slightly higher rating of 3 out of 10), then progress to a room full of friends (rating 5 out of 10 and then finally a room full of strangers)…this is just a very general example of “graded exposure” – get used to each level until the anxiety dissipates and then progress up to higher rating of anxiety of your feared-situation list.

In this way, you will learn to see the threat for what it really is, which is often less scary that you thought it would be and you also learn that you can cope with difficult situations. You will only know this by testing your beliefs out to see what happens!

You don’t need to live with anxiety – learn to challenge your fears. You may need to be out of your comfort zone more often but in the end you will expand your area of comfort and feel anxiety much less often and that is something we would all welcome!

Mandy X



Dialectical Behaviour Therapy


Counseling (Photo credit: Alan Cleaver)

Dialectical Behaviour Therapy

What is the difference between Dialectical behaviour Therapy (DBT) and Cognitive Behaviour Therapy (CBT)? In my private practice I mainly use a psychodynamic approach with Cognitive Behaviour therapy. Psychodynamic therapy works on the premise that many of our behaviours are learned in childhood and are maladaptive. These ineffective coping mechanisms thwart us and limit us in adulthood and becoming aware of these behavioural patterns is the first step in counteracting their negative effects.

Dialectical behaviour is type of cognitive behavioural therapy that focuses on the psychosocial aspects of a person’s psychology. It is based on the theory that some people react more intensely to experiences involving romantic partners, family and friends. A maladaptive coping mechanism causes distress and distorted thinking regarding social aspects of their lives. Dialectical Behaviour Therapy often consists of a group session element as well where people can learn from one another in a social setting. The following skills are learned in group DBT sessions:

Effective interpersonal skills

Distress tolerance/ reality acceptance skills

Emotional regulation

Mindfulness skills


Both Cognitive Behavioural Therapy and Dialectical Behaviour Therapy can incorporate exploring an individual’s past or history, to help an individual better understand how it may have impacted their current situation. Discussion of one’s past is not a focus in either form of therapy.

Both types of psychotherapy have strong research backing and have been proven to help a person with a wide range of mental health concerns.

Benefits of Dialectical Behaviour Therapy:

The following are some of the benefits of DBT:


  • Increased awareness of destructive behaviour relating to interpersonal relationships as well as areas where self sabotage exists
  •  Decrease high risk suicidal and self-harming behaviour
  •  Decrease behaviour that interfere with quality of life
  •  Learning and mastering behaviour skills for mood-independent life choices
  •  Decrease symptoms related to trauma, stress, anxiety and depression
  •  Enhance and sustain self-respect
  •  Assistance with goal setting in order to create a life worth living


By focusing on facts rather than emotions or value judgments such as good/bad or fair/unfair, DBT patients enhance their abilities to respond positively and productively, without descending into self-blame or other destructive thoughts and behaviours.

Mandy X





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Practise what you preach

Deutsch: Phrenologie

Deutsch: Phrenologie (Photo credit: Wikipedia)

Do you practise what you preach? There are many hypocrites out there who say one thing and do another. It’s a psychological fact that we use different criteria to judge others than we do for ourselves. Depending on whether we are more optimistic (and possibly in denial in some ways) or more pessimistic in nature, we tend to have a skewed comparison effect.

If we’re optimistic, we see ourselves in a more positive light compared to others. I remember once being with a boyfriend who was incredibly selfish and at times emotionally abusive. He commented on a friend of his one day saying something like, “He is very selfish and never allows his wife to have an opinion”. I distinctly remember this comment because the week before this same man had told me that he didn’t want my belongings in his house (we were moving in together and he was quite wealthy) as they weren’t expensive enough and didn’t fit in with his stuff! I should’ve left him there and then…silly me.

If we are pessimistic we tend to judge others more favourably than we judge ourselves. We cut them more slack and give ourselves a hard time. The main reason I am writing this post today though is to talk about my work.

Every type of therapy that I do with my clients, I have tried myself. From cognitive behavioural therapy, act and commitment therapy  to schema theory, I have given them all a go. I truly believe that I cannot extol the virtues of certain therapies in my psychological toolkit without having tried them for myself.

Cognitive behavioural therapy has had the most significant effect on me. When I think about how I used to think ten years ago, I have become a much better ‘thought manager’. I am less anxious and I am more adept at worrying less about things I have no control over. This doesn’t mean I don’t get down or that my life is perfect. far from it but I no longer take life as seriously as I used to. I certainly have more belief in my own opinions and abilities which has had a wonderfully positive impact upon my achievements.

The most significant changes since doing counselling and psychological strategising are:

1) I like myself more.

2) I am more prepared to speak my mind and try new things.

3) Less worried about failure.

4) I feel more in control of my life and my emotions.

5) I don’t automatically assume that everyone else knows better than me.

6) I don’t blame anyone else for where I am in life.

7)I have a better understanding of my strengths and weaknesses.

We never stop learning and we never stop making mistakes. That’s life and when we accept that we feel happier to ‘muck in’ and just get on with it. When you don’t take yourself too seriously, you can be one of those people that dances to your own beat and doesn’t worry about what others think. We have to honour our own existence by doing what we feel is important and in line with our own values instead of following what is expected of us. This is the most sure fire way to lose yourself.

When your inner and outer worlds are congruent, true peace of mind follows. By this I mean

– when your ideal self (the image you show to others) and your true self (the real you underneath that feels vulnerable and has insecurities) mirror each other – you feel more complete. There is no incongruency and this is the ultimate state to strive for.

Mandy X




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