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The following article appeared in the Chiswick Herald on the 1st February.
 
Sometimes people with anxiety start to withdraw and avoid things, people and situations where they experience heightened anxiety. Avoidance is a valid coping mechanism and a tool that can facilitate recovery from trauma but if you or someone you know is gradually withdrawing with no decrease in anxiety then maybe its not the most helpful one!
 
In fact this might be considered as “colluding” with anxiety, and collusion ultimately leads to greater anxiety.
 
Anxiety is a heightened state that is identifiable through a combination of physical, psychological and behavioural experiences. Anxiety is different to stress in that it is a longer term condition and it is for this very reason that it can be harder to identify and therefore to treat.

 

It is not uncommon for people to be unaware that they suffer from anxiety until they realise that other people do not feel like them and again, being able to identify anxiety can depend upon its cause. Where there has been a significant life event it can be easier to spot than if someone has been anxious since a very early age. Again it is common for people to not recognise anxiety because the way they experience life has never been any different. For people who have this type of anxiety it can be helpful to think about a persons early years and any childhood traumas.

 

And of course anxiety is linked to a wide range of other unpleasant experiences such as panic attacks, agoraphobia, other phobia’s, obsessive compulsive disorder etc. Long term anxiety may also result in clinical depression or other mental health conditions - so once recognised it is really important to start developing ways to manage and hopefully recover from anxiety.

  

Returning to colluding with anxiety, a common experience is for sufferers to be anxious about being anxious and this is contrary to how anxiety can be alleviated. This cycle which can only result in an escalation of the anxiety must first be broken. We need to recognise that the anxiety has a message for us - one that we need to understand and to do this we must adopt a “kindly curiosity” towards the experience of the anxiety.
 
Imagine someone who cannot travel on the Underground, how might you apply the idea of kindly curiosity? Here are a list of questions that might be helpfully worked through.
 
  1. What is the impact on the person of not being able to travel on the Underground? Answers may be practical for example the cost of having to get taxis or more personal for example feeling unhappy with oneself or a combination. 
  2. Has something happened on the Underground? If yes then traumas that have resulted in an unwanted change are something that people take to counselling.
  3. When did this anxiety first appear?
  4. Was there anything else going on in life at the time?
  5. What has been tried to manage or treat the anxiety?
  6. What hasn’t been tried?
  7. Have you looked for information on using the underground, anxiety and how other people cope?
  8. What do you think and feel about what you have found out?
  9. What would you like to do about it?
  10. What might you find supportive / helpful?
  11. Who might you find helpful / supportive?
  12. Is there any reason why you do not try to deal with this or why it is hard to get help?
  13. If a person you cared for was in your situation what would you say to them, or how would you help them?
 
 
In therapy, one of the approaches to overcome an anxiety linked to a specific situation is firstly to talk it through, secondly to talk about information that might be helpful and then thirdly to draw up a plan of action.
 
A plan of action in terms of travelling on the Underground will be tailored to the specific person, based upon what they want to do, what has worked for other people and what the therapist and the person senses to be manageable.
 
For example, the sufferer might first of all watch videos of underground journeys, they might then go to visit an Underground station, then they might take a train just one stop on an overground section before taking longer journeys. They might have a therapist or friend / relative travel with them the first few times, drop them at the station or meet them at the other end. They might take their mobile phone with them and have someone lined up who they can call. They might take a book or listen to music, carry food or water….. As you can see so many options. 
 
The important thing is to be kind, take small steps and listen to what feels manageable. 
 
The Underground is a fairly common example and one that can cause anything from mild to debilitating anxiety. If either yourself or someone you know is struggling with anxiety remember this is a very common problem and it is treatable.
 
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Our latest article has been published in the Chiswick Herald, click here to visit the site or read below.

Here’s how to give yourself a summer mental health and wellbeing check up!
 
Summer can be a great time to take stock. The disruption in our usual routines can remind us that there are different ways to live and this can be enough to help us make some simple but hugely important changes.
 
The summer holiday is for many people the one time when they feel they have earned the right to do what they enjoy. As a result it is a time when many things are enjoyed - some of which maybe vital for well being - but how can you decide what is vital and what is merely pleasure for pleasures sake? 
 
It is a natural tendency for us to let the things that support us fall by the wayside at times when the pressure of everyday life demands sacrifices. I use the word sacrifice intentionally because what I see people doing every day is “sacrificing” something. Firstly because there is a hope that some reward will follow and secondly because a sacrifice is mostly seen and understood as positive thing. Everyone has heard something said like “she sacrificed the best years of her live for  her children and see how they repay her”, or “he worked for them for years, put up with poor pay and now look at how he’s been treated”. It doesn’t change what has happened but it does position the one who has sacrificed as the one to be judged more sympathetically. 
 
In other words I think people can find themselves leading hard lives because they prefer to think of themselves as someone who sacrifices. And then of course people don’t sacrifice overtime for time with their families, don’t sacrifice promotion for staying in a job they are actually enjoying, don’t sacrifice the rush hour commute in favour of a yoga class, don’t sacrifice the hour they spend each day reading bad news for an hour listening to music, reading, walking, making love… A sacrifice seems to be about giving up something we find positive…
 
My point is simply that the judgements and beliefs we hold about the way to approach life will affect the way in which we make decisions and not always for the best! So use the summer holidays to give yourself a mental health and wellbeing check up and heres how. 
 
Think about and write down:
 
1. The things you do during your usual routines that you are pretty certain are unhealthy / unhelpful, the things you would like to change or improve for example, lose weight, drink less, exercise more etc. 
 
2. Your life when you are in your usual routines and without stopping to analyse/censure what comes to mind list the times when you have the most positive feelings/thoughts/bodily sensations.
 
3. When you get the most negative feelings/thoughts/bodily sensations.
 
4. How this compares to when you are on holiday.
 
 
Now:
 
1 Write down the three most significant things that you DO NOT feel compelled by when on holiday. For example “on holiday I do not feel under pressure to get everywhere on time” again do not stop to analyse or censure.
 
2. Again without analysing / censuring, write down what would need to be different for example, “I would need to start working part time”.
 
3. NOW is the time to allow yourself to analyse and censure your reactions to these changes - so list all the reasons why you do not think you can change.
 
This is the point at which you will see all your judgements and belief’s - ask yourself “what of the things I’ve listed here do I actually know, where does this come from and what evidence do I have that this applies to me and my life?”.
 
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Our latest article on reducing anxiety has been published in the Chiswick Herald, please click here or read below:

Reduce stress and anxiety FAST
 
Below are five things to think about to make you feel calmer:
 
  1. Are you taking things too personally?
 
We get upset with other people when our expectations are not the same. There is nothing wrong with expectations as long as you recognise them for what they are - our humanly attempt to reduce our anxiety about living. We try to reduce our anxiety by finding meaning and purpose and with this we form personal views based on all our experiences of living. What we have liked and not liked is fed into developing our personal framework of what we think is good and bad - it sets our expectations and our opinions and these become what we believe to be true about life.
 
When we come into conflict with another it is because our “truth” does not agree with their’s. We don’t want to think we might be wrong because that undermines our confidence in how we make sense of our lives, so it is natural to defend our “truth”. When we defend we come into conflict and this often causes more conflict. 
 
Conflicting positions present us with a challenge so instead of getting angry try to think about conflict situations like this:
 
“I am right, but only for myself. The other person is also right, but only for themselves. We are in conflict because we are both anxious to be right.”
 
  1. Are you aware of how your time of life is affecting your stress levels?
 
Because we are so busy living our lives we tend to forget to take stock and think about just how much stress might be coming from our stage in life. Adolescence tends to get most publicity as it is the most easily recognisable - due most likely to its nature of being condensed into just a few short years - but differing pressures are with us throughout live. Relationships, careers, financial security, our health, families, retirements, redundancies, bereavements all bring pressure to what we do everyday. Stages often talked about are coming of age, leaving home, leaving university, 30, 40, 50, 60, empty nests, loss of parents, retirement…..
 
So if you are stressed and anxious think about the people you love most and think about how they put pressure on themselves and how you wish they would just relax. And now think about where you are in life, what disappointments have you carried from previous times, what impact might these be having today? What are your hopes for the current time and how are you doing with your plans? And what do you want for the future? You might find yourself tempted to start writing lists but maybe you could try to think like this:
 
“I am right to feel under pressure given everything I want for my life, it is what everyone does. I am anxious just like everyone else”
 
  1. Are you seeking perfection?
 
Do you describe yourself as a perfectionist? Or do other people see you as a perfectionist? It is natural to want to get things right and as the above questions show anxiety comes from expectations and standards. To be a perfect human though is to make mistakes - if you want to be a perfectionist then don’t strive for perfection. Another way of looking at things is to try and aim for good enough in all things rather than seeking perfection in some areas at the cost of others. You might like to think like this:
 
“To be perfect requires imperfection, my imperfections make me perfect.”
 
  1. Are you colluding with your anxieties?
 
Think about all the things that reduce your stress. Think of times when you have felt least stress, places that induce calm, people with whom you feel relaxed, ways in which you can release stress. Excellent you have just completed an exercise in not colluding with anxiety. When you feel stressed or anxious it will affect how you make decisions and not necessarily for the best. Feeling calm and level headed is a good starting point for decision making. So try thinking like this:
 
“Of course I WANT to think about the things that are stressing me so what I NEED to do is think about all the things that are not stressing me”
 
  1. Are your taking care of yourself?
 
A great way to turn yourself away from stress is to develop a kind mindset towards self care. DOING taking care of yourself is a great way to reduce from stress and anxiety that arises from THINKING about looking after ourselves. Recent research has shown that just putting one foot in front of another reduces stress, anxiety and depression. So when it comes to exercise, nutrition, finances, relationships, careers, hobbies, spirituality you will feel better just by putting one foot in front of the other. If you are still struggling with your thinking try this:
 
“To feel better I just need to approach everything with the aim of putting one foot in front of the other.”
 
 
 
We hope you have found this article helpful but if you have been experiencing anxiety for a prolonged period then we advise seeking professional help. In addition, anxiety and stress can also come from underlying health issues so if you are suffering from stress and anxiety symptoms we always advise you check out your health with your GP.
 
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Our latest article has been published in the Chiswick Herald, please click here or read it below.

How to make the School Holidays the best ever!
 
The school holidays are a wonderful opportunity for families to strengthen and improve their relationships and yet for many parents they can bring stress and anxiety. For some parents it can be more about surviving than enjoying the school holidays.
 
The first thing to remember is that as parents you are in charge and so before anything else take some time to think about how best to manage what can be a massive undertaking in terms of balancing time, logistics, money, competing demands and complex relationships.
 
Principle one - Look after yourself before looking after others
 
Priority number one is the well being of the person in charge and yes that is you. So it is really important that you know what you can manage and that you apply your knowledge about what will work best. After all it is you who will have to manage whatever plans are made. Here are a list of questions to help you think about this:-
 
How are you? 
How’s life for you at the moment?
What is concerning you at the moment?
How do you feel about family life?
What would you like to get out of the summer holidays?
Why do you think you want this - is this what you want or need?
Now take a moment to now think what you NEED from the holidays?
What do you not want to happen?
Thinking through how the family is at the moment what do you foresee?
In terms of current challenges what have you tried and what haven’t you tried?
Do you feel supported? Again, if not what have you tried and not tried?
How self critical are you? Yes difficult behaviours in the family may well be coming from the dynamic created by traits that you see as your own shortcomings but be kind to yourself. Don’t make yourself do things because you feel you should - find creative ways to achieve the same aims!
 
Principle two - Use a constructive and collaborative communication style
 
Avoid escalation of conflict by simplifying your communication. When you feel that conflict may arise use this four step way of ensuring you express yourself clearly and in a non confrontational way.
 
  1. State the fact/s
  2. Say what your response say how you feel and think (never say you make me feel / think because that will escalate conflict)
  3. Explain why this matters to you
  4. Share the problem you now have and ask them for their input
 
For example one of your children arrives late, this means you will be under pressure to get somewhere on time, this is something that you have said is important to you, you feel angry and stressed. It also means that it is unlikely you can fit in both of the things that were planned.
 
  1. I said we would need to leave at 9am but you have arrived at 9.45am
  2. I feel upset, angry and under pressure
  3. I want to be a good parent and being late means to me that I am failing but being late also means I end up under pressure 
  4. Now that we are 45 minutes I do not think we can do what we had planned, I need help in deciding what to change. Do you have any thoughts?
 
Principle three - Maintaining boundaries
 
A constructive and collaborative style of communication does not mean that you now let others decide what happens. Particularly if you are clearly the one with the designated responsibility. The key concern now is finding a new plan that works for everyone - including you. With the example above you may decide to take out one of the activities that had been planned. Before you do this double check with your motivations to ensure that this is the most practical solution - that the decision is not an outlet for your difficult feelings but an answer to the dilemma you face. The message you want your children to have is that when things go badly in life it is important to take the course of action that best puts things back on track. And if you think some form of punishment is also necessary then that is a different issue and should be handled as such.
 
So you have said your piece and have invited help but it is now your decision to decide what should happen next. Clarity about who is in charge is ultimately about safety. If any of the children do not like your decision remind them of the fact that you are responsible and that in life it is important that people take their responsibilities seriously. And of course remind them that one day they will be in the position of responsibility and then they will need to be the one making the decision.
 
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Here is our latest article from the Chiswick Herald reviewing a Yoga retreat and Yoga approach. Please read below or see it here on the Chiswick Herald site.

Moving from the couch to the yoga mat

Many of my patients are often already practicing or take up “physical” activities such as Pilates, Tai Chi, Qigong or Yoga. Over the years I’ve tried yoga on a number of occasions but not been able to find one that I’ve wanted to continue. So when I heard of a form of yoga where the underlying assumption is about uncovering or more accurately rediscovering the innate expertise we have to live a healthier life, an association I make with therapy - I wanted to explore further. 

Fairlie Gibson teaches this yoga in London but also runs holidays to teach this approach, she told me “the yoga holidays I offer are based upon an approach practiced and shared by Vanda Scaravelli. Vanda didn’t want to give her style a new name but it has become known as Scaravelli inspired yoga. We set the holidays in either beautiful mountainous Andalucia or on the gorgeous turquois coast on Southern Turkey. The aim of these holidays is give the participants, no matter what their experience of yoga, the chance to experience this, as yet, little known approach”.

By way of some background and before I talk more about the potential interplay and complementarity of this yoga to therapy I want to go back in history as I think it provides some basic and helpful context. The word disease has its origins in 14c. coming from Old French desaise and it was an holistic term covering the experience of both physical and emotional distress. It is simply the opposite of ease so the experience of “dis”ease. As medical science has found treatable causes for many sources of distress the word disease has become associated primarily with the physical. With “ill at ease” being used instead of disease but also having the connotation of some minor discomfort. In the same way the word patient has its origin in patience meaning someone that endures pain and suffering.

The importance of all this is recognition that the physical and emotional are in fact inseparable. If you feel “dis-ease” then do see your doctor but remember that when you reach the limits of what current medical science can provide you will need to access your own resources to treat or manage any remaining “dis-ease.”

The relationship I build with patients aims to bring a sense of safety and relaxation as we spend time together. That sense of relaxation or comfort enabling us to look again at how life is being lived and identify misunderstandings, unhelpful thinking, unhelpful habits, automatic responses and physical actions that have become fixed when in reality in any given moment and in any situation a range of options will be available. In short our way of living or being that was helpful in the past may not be the most helpful now.

So now back to the yoga. The experience of many who have trained in yoga is the need to learn new moves, push the body, stretch to the limit in other words to add more instruction and to have to work harder – all at a time when they have been drawn to a physical activity because they want to make life better. Resulting struggles to achieve the pose, remember the sequences, to practice regularly combined with physical injury, negative thoughts and feelings can all lead to the exact opposite of what was hoped. 

Scaravelli is known to have said “if you are kind to your body, it will respond in an incredible way”. My own experience of the yoga was first and foremost one of kindness, creating space, allowing, appreciating and only then to move the body in ways that are known to result in greater flexibility, strength and sense of well being.

Fairlie told me “It’s about coming home to yourself rather than learning something new or put another way, about unlearning and then being with ourselves in a different way”. She continued “We have become so absorbed in the need to achieve. In yoga visuals of practitioners bent double in seemingly impossible stances have resulted in a lot of pressure to achieve whereas it is more about experiencing freedom in the body. The pace of the practice is such that there is great emphasis on creating space and allowing time for the body to find its optimum”. 

Fairlie Gibson - Scaravelli Inspired Yoga

As the week progressed I found myself feeling very at ease in positions that felt wonderfully natural only to realize I was actually adopting positions that I would have anticipated requiring a huge amount of effort. I’m not saying it is easy, its not about whether its easy or hard its more about what can happen once you have let go of trying. Fairlie called this “effortless effort.” And I find myself concluding that the space this yoga creates and the freedom it generates to allow for change is indeed very therapeutic. This is a form of yoga I am interesting in continuing to practice. 

Details of upcoming yoga holidays can be found on Fairlie’s website www.freeingthebody.com