Tag Archives: Counselling

Tips on how to get the most therapeutic value out of psychological therapy

 

Counselling-session2

Tips on how to get the most therapeutic value out of psychological therapy

You are emotionally struggling – weighed down by different feelings or profound sadness/anxiety/hopelessness.. you might have been going through a number of things that life threw at you from left, right and centre. You might have just realised how sad you have been throughout your whole life. You might have just lost someone, a relationship or a sense of self/achievement/control. And you are thinking about talking to a stranger all about it. Perhaps someone said ‘you better go and talk to a professional about it’. Maybe your GP was not happy to prescribe any medication at this point. Maybe you don’t want to take any pills.

As a therapist, I can tell you that it’s not an easy thing at all. You are letting a stranger see your inner self and your life including the parts you don’t want to think about (although not all therapy will result in digging up the past or your deepest darkest secrets). You have to verbalise how you feel, which can be the most daunting thing ever. You have the right to feel nervous and apprehensive, as well as feeling relieved (because a. you have decided to get help, b. there’s actually someone whom you can unload your internal burden without feeling guilty c. Things might change. In a good way. There’s hope.)
So, it is really, really important that you get into the right type of therapy and you get the most out of it. Based on my 8 years of experience in mental health service, I thought these tips might be helpful for people who are in need of and considering accessing psychological therapy.

1. Do tell your GP how you feel and how you might need emotional support/psychological therapy from a professional. GP may not know about all types of therapy but can point you in the right direction.

2. Not all therapy is ‘counselling’. If you say you need counselling, GP might only give you option for counselling. There are Cognitive behavioural therapy (CBT), psychodynamic therapy, systemic therapy…a variety types of therapy. Bear in mind, though, CBT is the evidence-based therapy recommended for various mood disorders (depression, anxiety, panic, PTSD, OCD, phobia all included) by the National Institute for Health and Care Excellence. You can do a little research on different types of psychological therapy.

3. You do need an assessment if you are unsure what type of therapy would be most helpful for what you are going through right now. Accessing your local IAPT service can help you with this. Their assessment will determine whether you would benefit from short-term treatment like CBT or you require more long-term/holistic treatment.

4. It really helps if you can think of what you want to achieve from the therapy e.g you want to improve your mood so that you can deal with your life stressors better, you want to reduce fear that’s been really getting in the way in your daily life, you want to resolve your feelings around your childhood. However, sometimes we are so overwhelmed we just can’t think clearly – where to start, what we need, what to focus on first. The person who assesses you might suggest one area to focus on. You might think ‘that’s not gonna be enough’ and feel hopeless/frustrated BUT remember, you need to start somewhere and the assessor is likely to be suggesting something that you can manage with a therapist’s help so try to put aside the uncomfortable feeling and see where it takes you/how it can help you.

5. At times, therapists (especially in NHS) encounter people who ask ‘are you qualified enough? Are you a psychiatrist? How old are you?’. When we are badly injured and our life feels upside down, we wouldn’t ask the consulting doctors and nurses these questions. Therapists need the same level of trust and respect and starting your assessment/therapy with scepticism is not likely to help you with being open and honest during the assessment, which is very important.

6. Just because you are going through 10 different problems, it does not mean that your treatment has to be the most complex, intense one. There are people who say ‘my problem is really complicated, I need to see a psychiatrist only’. If you are experiencing symptoms of psychosis such as visual/auditory hallucination, frequent urges to seriously harm yourself or others, or your paranoia is significantly disabling you, you may require psychiatric assessment and medication, and therefore a psychiatrist. However, try not to jump to conclusions and, again, be open-minded when you discuss your difficulties with your GP and assessor. You may only require a short-term CBT to understand the link between current difficulties and to learn to cope with them with new coping techniques (cognitive and behavioural), for example. Psychological therapy is most often delivered by psychologists and psychological therapists such as CBT therapists, psychological wellbeing practitioners and counsellors who are trained to deliver therapy.

7. Don’t be put off by the word ‘short-term’. It is not belittling your difficulties. Breaking down your difficult emotions and working through them one by one are more likely to have long-term benefit than trying to work on everything at the same time. Think of it this way – you are injured in several different places. Rather than going through a 24-hour surgery which will overwhelm your body and could be more detrimental, you get one treatment for one area, let it heal then move onto the next treatment, so have some gaps in between. You may also find that the first short-term treatment gives you what you need to manage/tackle some of the other difficulties, which can lead to great sense of independence and self efficacy.

8. Often drinking or taking drugs is used to cope with difficult emotions. However, when there’s been this self-medicating going on for some time, it can be difficult for your therapist to get a true picture of your current mental health because large amount and frequent use of alcohol/drug is very likely to have affected your mental health e.g. Exacerbated your anxiety, caused ‘extra’ factors around depression or panic etc. You are likely to be asked to engage with drug and alcohol support service first. This is not rejecting your difficulties or simplifying your difficulties as ‘substance misuse’. It’s not beneficial at all to be stuck in the middle – Therapy trying to pull you up to challenge dysfunctional thoughts while the impact of alcohol/drug is pushing you down to more dysfunctional thoughts and poorer concentration, for example. You will feel stuck, which may lead to further frustration/hopeless feeling/fear/disappointment.

9. Once you start the therapy, imagine that you have a driving instructor sitting next to you. You are still the driver. If you don’t put your foot down on that accelerator, your therapist won’t start the car for you. If you refuse to do that parallel parking although you were given and shown the knowledge and techniques that you require, your therapist will not do it for you. It is not because we refuse to help but because
We are here to help you become an independent driver, not to help you be a passenger.
Therapy is there to empower you, not to take the control away from you.

 

This post was written by an experienced colleague of mine – Scarlett Gallimore. To find out more click on the links below:

Links:

Link for further info

What is Cognitive Behavioural Therapy?

 

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What is Cognitive Behavioural Therapy?

Past events and our upbringings shape the way we think. As we progress through life we begin to make assumptions about ourselves and others – some of these thoughts will be helpful and others will be unhelpful. In the same way, some assumptions/thoughts will be accurate and some will be inaccurate. The longer we have thought in a certain way, the harder it is to shift and change. We end up over time having core beliefs about ourselves and the world, also referred to as “rules for living”.

Rules for living often take the form of “if this…then that”. For example: If I go out and socialise I will end up making a fool of myself. Or…if I get into another relationship I will get hurt or – If I don’t please others I will be disliked and rejected. Core beliefs are often in the form of:

“I am not good enough”; “I am a failure” and so on.

So, our past experiences create our beliefs and assumptions about the world which appear as “if this ..then that” thoughts or “must and should” statements.

Becoming more aware of your “must and should” statements is one key way to begin uncovering your rules for living. We can’t change the past but we CAN update our beliefs about the worldand ourselves as many of the core beliefs we hold are often outdated and incorrect.

We learn false beliefs from other, especially our parents and we internalise these thought. If your parents were critical, we begin to see ourselves in the same way (eg. I am stupid, fat, ugly, etc) and we act in accordance with these thoughts by withdrawing, avoiding or finding ways to hide our assumed failings and inadequacies.

Cognitive behavioural therapy is a brilliant way to identify inaccurate thoughts and start to replace them with healthier, more helpful thoughts. CBT also involves setting up behavioural experiments to test  out our faulty assumptions to show us how they aren’t true.

If you find yourself repeating negative patterns of behaviour, cognitive behavioural therapy (CBT) might work for you. CBT is available in many areas and most CBT therapists offer skype sessions too – so it can be offered from anywhere in the world.

I offer CBT online and if I cannot help you I can refer to another CBT therapist who can.

Mandy X

 

How to have a successful relationship

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How to have a successful relationship

Stop scoring points

A successful relationship always involves acting with integrity, Even if your partner doesn’t. Respond in the best possible way and treat them as you would wish to be treated. Stop keeping score as this leads to resentment. Communicate about what isn’t working rather than using this resentment to get back at the other person in order to even the ‘playing field’.

No game playing

They didn’t test, so I not going to text them either. This is short lived nonsense that will only temporarily make you feel better. Act as you wish to continue in the relationship. Game playing is the beginning of the end if it becomes a habit in the relationship and it reduces trust.

Be honest and open

Speak up when you feel the need. Talk about what’s on your mind as it fosters intimacy and a stronger bond. Be human. Be vulnerable. Take that risk for excellent rewards of a successful relationship.

Communicate as much as possible – don’t suppress

If something bothers you don’t let it fester. Pick the right moment and clear the air. Try to communicate regularly and dissipate any inner tension in doing so. You will feel closer and do better as a couple in the long run.

Pick your battles

Not every indiscretion needs to become a point of conflict. Decide on your boundaries and your ‘deal breaker’ areas and stick to those. Regular bickering and arguing ruins relationships.

Don’t try to change the other person’s fundamental characteristics, personality traits

If they are outgoing and lively, let them be that way even if that’s not how you behave. Stifle someone and you suppress their spirit and dilute their essence and they will end up resenting you for it. Give them freedom to be who they want to be and they will love you more for it.

Treat each other with respect

When respect goes you may as well give up. Respect means you still honour that person and don’t want to hurt them. When respect goes, the gloves are off.

Be assertive, don’t use passive aggressive tactics

Ask for what you want – don’t expect the other person to guess if you have not explicitly told them. Use assertive script to get your needs met: “when you….I feel…so what I’d like is…”

Using this format fosters cooperation rather than a defensive reaction.

Always work towards the ultimate goal of the relationship – to be close, intimate and best companions

When you feel the urge to do something that might damage the relationship, ask yourself if that action will contribute to a happy healthy relationship or not. Use this to guide your behaviour.

Healthy happy and successful relationships are within the reach of all of us. Tread carefully and be thoughtful and love can be yours forever.

Mandy X

 

Cognitive behavioural therapy and anxiety

 

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Cognitive behavioural therapy and anxiety

Cognitive behavioural therapy (CBT) is a great intervention for anxiety. Understanding where anxiety comes from is extremely useful in being able to tackle feelings of fear and doubt creeping. Cognitive behavioural therapy looks at the interaction between the thoughts we are having, the feelings that arise from these thoughts, the behaviour that ensues as well as physical symptoms associated with the thoughts feelings and behaviour. Anxiety is part of the normal response when we feel fear. The moment we feel threatened our bodies go into “fight, flight or freeze mode”. This mode consists of physical sensations such as sweating, heart palpitations, dry throat and so on. This is the body signal that something is wrong. Researchers refer to the old part of our brain as being the part that reacts without thinking-the part that our Neanderthal ancestors used. The newer part the brain include the frontal lobe which separates us from other organisms. The frontal lobe is responsible for reasoning and allows us to think things through rather than react instinctively. Cognitive behavioural therapy helps us to use the newer part of our brain by stopping and thinking.

We all have ways of reducing anxiety but sometimes the habits we gain end up complicating matters even further. For example, someone who is afraid they will lose their job may begin drinking more alcohol in an attempt to reduce their anxiety. This unhelpful behaviour will compound the initial problem rather than resolve it. Cognitive behavioural therapy examines our unhelpful and irrational thoughts helps us to replace these dysfunctional thoughts with more realistic ones.

For example: a recent client told me that they are a failure in life. When we look for the evidence of this we may find some examples that led to the client to believing this but they will also be just as many examples that refute this idea. Cognitive behavioural therapy teaches us to reframe our core beliefs. An alternative way to think might be: I may make mistakes in life that does not mean that I am a complete failure.

Part of cognitive behavioural therapy also involves looking at the behaviour that comes from the unhelpful thinking. Typical examples of unhelpful thinking are-over generalising, black and white thinking (a.k.a. all or nothing), catastrophising and negative filter (where we only look at what is wrong and ignore the positives). The above thinking will lead to unhealthy behaviours. Cognitive behavioural therapy involves challenging thinking by setting up social experiments to challenge the thoughts. For example: if someone feels anxious about going to a movie on their own because they worry about what others might think, a behavioural experiment might involve taking small steps towards going to a movie on their own. Usually what happens is that the anticipation and the thoughts of what might happen never arrive and this helps a person to reframe the thinking. This is also known as cognitive restructuring.

Challenging thinking and doing what you fear of great ways to reduce anxiety. Having goals and purpose in life are also a great way to keep anxiety at bay. When we have direction and purpose it is more likely that we will spend less time ruminating and obsessing, often over things we have no control over. Unfortunately anxiety is part of life for some of us is far more intrusive than it used to be. Thanks to cognitive behavioural therapy, there is now an effective method to counteract the distressing effects of anxiety.

Mandy X

Photo by spaceodissey

What happens in therapy

 

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What happens in therapy

I have been a therapist in private practice since 2009 and have come across a variety of people with different problems and troubles. Counsellors and therapists may have similar training but we all have our own particular style and that is why it is important to feel at ease with the person you choose to reveal your personal issues to.

My personal approach is collaborative – what I mean by this is I see the ‘relationship’ between me and my client as a joint effort. Kind of like holding hands and walking down the road together. I guide the client but they do all the work. Most of my sessions are light hearted and we often have a giggle when appropriate. My sessions focus on empowering the client and helping them to uncover where they are getting stuck in life.

Of course, certain ethical boundaries should always be in place such as not engaging in a romantic relationship with a client – this is a big NO-NO. Nor should a therapist have a secondary relationship with a client, for example – where the therapist and the client are school governors together.

I practise cognitive behavioural therapy mostly and this focuses on how we perceive what is happening to us as opposed to what is actually happening to us. What are we telling ourselves about what is happening in our lives – do we have many negative thoughts that make us unhappy? Do we have many wrong assumptions about life? CBT looks at the inner monologue and gets us to challenge ingrained way of thinking that may no longer works for us anymore. CBT deals mainly with current issues but does look at relevant issues from the past as well.

An example:  life event: a person loses their job.

Person A’s perception: This is awful. I will never find another job. I am ruined.

Person B’s perception: I’m not overjoyed about losing my job but this is an opportunity to find a job that possibly pays better and one that is closer to home.

Which person is more likely to feel happier? No doubt Person B will fare better despite the fact that the same event has happened to them both. What you think about life affects your emotions and this in turn influences your behaviour and the negative cycle continues.

The therapy room is a rare example of a safe place where you can completely focus on yourself and have someone listen who is non judgemental and has your best interests at heart. It’s a pretty fantastic experience, one I would definitely recommend!

Mandy X

 

 

 

Photo by Joe Houghton

What is counselling?

 

counselling photo

What is counselling?

I’ve been a counsellor for such a long time that I sometimes forget what an alien concept counselling can be for some people. I run a private practice 30 minutes outside of London seeing couples and individuals who are experiencing problems.

Typical issues that people seek counselling for are:

  • Relationship issues – trouble communicating, break ups, marital issues, abusive relationships
  • Depression, anxiety, panic attacks
  • Phobias
  • Addiction
  • Low self esteem, low confidence, failure to thrive

What counselling can help with:

Counselling can help identify thoughts that are unhelpful and that are contributing to problems in life. When we listen to our negative thinking, we often end up in a self-fulfilling prophecy: one where the  negative thoughts begin to manifest in life.

For example, if our inner talk tells us we are fat, ugly and useless, our body language will mirror this inner world that we create and others will respond to the negative body language by avoiding us. We then use this incorrectly as evidence that our thoughts are true instead of seeing that our faulty thinking may have helped create the situation in the first place.

Counselling offers a safe, non judgemental place to talk about issues that worry us. Often, in the real world we can’t talk about the things we can discuss in counselling. Reassurance and objective input can be extremely useful in changing the status quo.

Counselling also helps us to understand where the issues/behaviour might be coming from and how we can go about changing things for the positive.

What counselling can’t help with:

Counselling needs input from the client to work. It requires effort to change bad habits and can be quite exhausting in many ways. Part of counselling involves ‘unlearning’ habitual patterns of behaviour (many picked up in childhood) that work against us.

Counselling can’t make life 100% perfect. It can help you be more resilient and find better ways to cope when life gets tough.

Counselling is a fantastic way to understand yourself better and improve your self awareness. We can all learn more about ourselves and challenge our existing ways of doing things.

Mandy X

 

Photo by Joe Houghton

therapy couch

The Therapy Couch

 

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The Therapy Couch

I talk a lot about my clients in my blog posts so I thought it would be a good idea to show you where my clients come and relax. I am an unusual counsellor as I always offer my clients a drink before we start the session.  Tea, coffee or water just in case you were wondering. No alcohol available 😉

Clients talk about everything with me from family/relationship troubles to seeking clarity on their thinking about certain situations. When we are too emotionally involved in something we sometimes lose clarity and irrational thought takes over. The emotional brain is extremely powerful and can overwhelm the thinking/rational brain easily.

The view from the couch:

therapy room view

 

One of my favourite quotes above the window:

happiness is an inside job

 

It makes sense to offer a less clinical environment for someone who is about to open up to a stranger about their innermost fears and personal troubles. Professional boundaries are still adhered to, but being personable and creating rapport are an essential part of the package I offer.

Mandy X

top 10 reasons people get counselling inforgraphic

Top 10 Reasons why people get counselling

 

Top 10 Reasons why people get counselling

I’ve put this infographic together which shows the top reasons why people get counselling.Many clients have come to see me over the past few years for counselling and psychotherapy and these ten reasons have been the most common.

 

top 10 reasons people get counselling inforgraphic