How I work

Life isn’t always easy

In the pressure of the modern world we can find ourselves struggling with difficulties that seem insurmountable on our own.  Whether it’s stress at work, the loss of a loved one, or a change in family circumstances, the impact of difficult events can have a negative effect on how we feel, the way we think, how we behave, and on our physical wellbeing.

Problems can manifest in many different ways. In depression, for example, we can feel trapped in our feelings of loss or failure making our view of ourselves and the world more negative, and the future seem hopeless.  It can be hard to feel motivated to do anything and we may give up doing things that previously gave us pleasure, finding them too challenging or ultimately pointless. We may become more tearful or easily irritated, snapping at loved ones we know are trying to help.

Anxiety and worry are other common problems. Panic attacks are intensely frightening and a phobia can be disabling. We may feel powerless to change, avoiding situations we see as increasingly dangerous or potentially humiliating. Social anxiety can mean we may dread making a speech or giving a presentation, or not feel able to stand up for ourselves . Generalised anxiety disorder (GAD) can lead to excessive, uncontrollable worrying, muscle tension and exhaustion. The obsessive thinking and compulsion to perform repeated rituals that characterise obsessive compulsive disorder (OCD) can lead to terrible distress and disruption in life and relationships. The symptoms of post-traumatic stress disorder (PTSD), such as flashbacks, avoidance and intense physical fear reactions, can severely restrict the range of activities and enjoyment we get from life.

Sometimes personal problems will have a major negative impact on your relationship and sometimes relationship problems will themselves cause other problems to be magnified. I offer couple therapy for common relationship and psychosexual problems that can lead to feelings of loneliness and isolation or to anger and conflict. Often the key to lasting change is to improve your relationship with significant others.

How can psychological therapy and CBT help?

Psychological therapy refers to a range of talking therapies, including psychotherapy, counselling and cognitive behavioural therapy (CBT). Psychological therapies can focus on an individual or a couple. I think of psychotherapy as a shared, collaborative journey towards wellness, where I act as a consultant for the kinds of changes you want to make in your life. Depending on your particular problems and on your goals from therapy, we might focus on one or more of the following areas: 1) making sense of your history and coming to terms with past events that still cause you pain; 2) living well in the present, including treating yourself with the same kindness and compassion that you would automatically extend to others; and 3) investing in actions that build a sense of hope and optimism for your future, including planning and setting goals that fit with your identity and values. The reason so much of my work uses CBT is because it has been shown to help with a wide range of common problems, including depression and anxiety. CBT helps me to think about the problems you bring in ways that help us to make sense of the reasons why you are struggling with this problem, what is keeping you stuck, and how treatment might help.

CBT is generally, though not always, a short-term treatment that emphasises the things we can do to help ourselves.  An initial assessment session will usually last up to 60 minutes, during which I will discuss with you the exact nature of the problems you’re having, when things started to get difficult, and ways that you’ve found helpful to cope with similar problems in the past.

Each person is unique, so I’ll also ask you about your current family circumstances, and your family and work history, in order to understand you better. At the end of the first session we’ll have made a start in trying to uncover the roots of your problems, and most importantly, what is stopping the problem from getting better.

Follow-up sessions are usually scheduled weekly at first, but could be fortnightly or longer depending on how your recovery is progressing, and are also generally of 60 minutes duration. We’ll discuss a plan of action to help get you back on the road to recovery. This will involve looking both at what you are doing that is either helpful or unhelpful, and whether the way you think about your problems is contributing to your difficulties.

We’ll look at different things you can try, and work out how to put those into practice between sessions. One of the reasons why CBT is a shorter-term therapy than many other approaches is because the work you put in between sessions plays a major part in speeding up your recovery.

Treatment is tailored to your specific needs so it is difficult to say in advance how many sessions you might need. Whilst some people only want a few sessions, typically treatment lasts approximately 6-18 sessions. Less commonly, treatment can last for 6 months or longer. Sometimes people will attend treatment for some weeks or months but then return for booster sessions to consolidate the changes they have made. If there are NICE guidelines that recommend appropriate interventions then I will suggest that we keep those firmly in mind throughout your treatment.

One of the ways that CBT differs from other forms of psychological therapy is that we believe that whilst talking about your problems can be a huge relief, it is unlikely to lead to lasting improvement on its own. That is why I will try both to lend an understanding, sympathetic and non-judgmental ear to your problems, but also help you to find ways to take charge of your own recovery. My aim is to help you learn to be your own therapist, so that you have the skills and confidence to deal with any problems that arise in the future.

All my work is confidential, subject to the limitations on confidentiality imposed by law and by what professional bodies recognise as best practice. My aim is to ensure my work with you is safe, effective and professional. I therefore receive regular supervision from a senior fellow professional. Client confidentiality is maintained by strict use of anonymity in supervision. I am happy to discuss confidentiality and supervision with you, either on the phone prior to us meeting, or in our initial session, as with any other questions you may have about the way I work.