Anxiety, Fears & Phobias

Anxiety, Fears and Phobias

Cognitive Behavioral Therapy (CBT) is the most popular therapy for anxiety disorders. In clinical studies it has been shown to be effective in the treatment of panic disorder, phobias, social anxiety disorder, and generalized anxiety disorder, among many others.

CBT for anxiety addresses the negative patterns and thinking errors in the way we look at the world and ourselves. 

Cognitive therapy examines how negative thoughts contribute to anxiety.
Behaviour therapy looks at how you behave and react in situations that trigger anxiety.

Social Phobia/Anxiety is an anxiety disorder where the person thinks that others will judge them negatively ("they'll think I'm stupid" etc), and it is therefore at its worse when with other people.

The attention is mainly self-focussed and the person indulges in mind-reading, in that they think they know what others are thinking of them and they try to interpret every glance and expression to give a clue as to what the other person is thinking about them.

Avoidance of social situations is a direct result because they don't want to feel the uncomfortable physical sensations of anxiety.  They deny themselves the opportunity to learn that maybe the situation could have been OK and they could have handled it.

Safety behaviours are developed to help them cope with situations that can't be axvoided, such as having someone with them, avoiding eye contact, holding or fiddling with something, trying to hide or having an escape plan (e.g. sit by door or in aisle, make an excuse to leave early).  This all increases the self-focus.

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CBT for Social Phobia

Cognitive Behavioural Therapy looks at the cycle of Social Phobia and teaches them to challenge the unhelpful thoughts and beliefs, learn to control the focus of attention, and change the behaviour to something more constructive.

Agoraphobia is an anxiety disorder which is characterised by a fear of and often avoidance of places or situations that might cause you to panic, make you feel trapped or embarrassed.

It often starts after having one or more panic attacks which leads to fearing another attack and avoidance of the place where it happened.  This can then generalise to avoiding public transport, being in open or enclosed spaces, standing in line or being in a crowd. 

Safety behaviours then develop such as needing someone to accompany you when you go out.  The fear can be so overwhelming that you may feel unable to leave your home.

With CBT you can escape the trap of agoraphobia and live a more enjoyable life.

CBT for Agoraphobia

CBT addresses the unhelpful thinking patterns and behaviours that are associated with agoraphobia.  It offers the client new ways of dealing with difficult situations and the anxieties they cause.

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People suffering from Irritable Bowel Syndrome often have an  increase in negative moods.  These psychological factors may be a cause of symptoms or a result of years of disrupted life activities and frequent periods of painful symptoms.

Anxiety may be related to specific events and sensations such as meals, abdominal pain, or diarrhea.  This can result in increased worry about the sensations, hyper-vigilance of symptoms and avoidance of any situation that they associate with the symptoms.  As a result life becomes more limited as they stick to safe places and activities which can result in increasing and pronging the anxiety.

There is now positive research to show Cognitive Behavioral Therapy combined with hypnosis, can have very a beneficial impact on IBS.


Cognitive Behavioral Therapy helps clients change their habitual thoughts, feelings, and behaviours that have contributed to stress and negative moods by applying a structured approach of exercises. 

Hypnosis for IBS

Hypnotherapy uses relaxation techniques and visualisation to help reduce symptoms and create helpful coping strategies.

Find out more about hypnotherapy here.

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Panic Attacks

A panic attack is the body’s natural alarm system (the fight-flight response) going off unnecessarily. Your brain thinks there is an immediate danger and sounds the alarm, a bit like a faulty car alarm that goes off every time it rains.

The symptoms of panic attacks such as feelings of dread, pounding heart, tingling skin, shortness of breath and tunnel vision are the fight or flight responses intended to keep you safe from a threat such as a physical attack. Sometimes though there is a build up of stress in the body over time that is then misinterpreted by the body as a present threat.  A threat to the ego such as giving a presentation as well as a threat to th physical body can also activate the fight or flight response.  The important thing to know about a panic attack is that it is a false alrm. 

Panic Disorder & Agoraphobia

Fear of having another panic attack, and/or avoiding places and circumstances where you believe an attack could occur, could be signs of Panic Disorder or Panic Disorder with Agoraphobia.

CBT for Panic

CBT is an effective, clinically-proven treatment for panic attacks, panic disorder, and related avoidance. Studies show that CBT is as effective as medication but with better long term results.

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Performance Anxiety

When you think about presenting, do you start to sweat and feel sick? Have you made excuses and missed out on promotions so that you don't have to stand up in front of people? If so, you are not alone.  For many of my clients it has been a guilty secret for years.

Most of us get anxious at the thought of making a presentation to a large group of people but some even feel uncomfortable introducing themselves on one of those training courses where you sit round and wait your turn!

CBT for Performance Anxiety

CBT looks at and aims to change the unhelpful thinking patterns which maintain the anxiety.  This often includes "worse case scenario" thinking which activates the fight/flight response.  CBT teaches you to think in a more constructive way and also teaches you strategies to manage your physical responses.

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Sleep Problems

At Psychotherapy Kingston, a CBT approach to sleep problems aims to improve sleep habits and behaviours.

The cognitive part of CBT teaches you to recognize and change beliefs that affect your ability to sleep. For instance, this may include learning how to control or eliminate negative thoughts and worries that keep you awake. The behavioural part of CBT helps you to develop good sleep habits and avoid behaviours that keep you from sleeping well.

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Stress Management

Stress is a build up of internal pressure that is generated by the world outside that causes us to feel 'under threat'. When we feel there is a danger to us we feel under pressure and undergo rapid physiological changes in the amygdala or 'old brain'. We are wired for fight or flight. When the danger has passed we should return to our original physical and mental balance.

Sometimes however, there is exhaustion when the threat is of greater intensity and duration than was expected. The person cannot cope, and either physical and/or mental health deteriorates. Symptoms of "burn out" then manifest themselves.

CBT For Stress Management

Therapy is focused on reducing the symptoms which can include axiety, depression, loss of control and insomnia etc.  Also teaching coping techniques such as breathing techniques, progressive muscle relaxation, problem solving skills and mindfulness.  The client learns how to pace themselves and recuperate between challenges.  Standard CBT is used to identify negative thoughts, beliefs and unhelpful behaviours and to create healthier patterns resulting in both mood and behaviour change.

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Traumatic Stress (PTSD)

At Psychotherapy Kingston, I use a structured approach to treating trauma using CBT and EMDR (see Supporting Therapies).

Traumatic stress or Post-Traumatic Stress Disorder (PTSD) usually occurs following a traumatic incident, or a series of less severe incidents.  Complex PTSD can be experienced as a result of repeated childhood traumas.

Most people will experience stress after a trauma, but the symptoms normally diminish after several weeks.  If the symptoms persist, then trauma-focused CBT or EMDR are currently recommended as the treatments of choice.

Flashbacks (traumatic re-living of the event, including images, sounds, emotions and physical sensations) and nightmares are common symptoms.  There is often severe anxiety and/or angry reactions or avoidance of triggers that may remind the individual of the incident in some way.

Often the incident is so overwhelming that the brain doesn't process the experience into a normal memory, so the experience stays as a current problem instead of a memory of a past event.  Each time there is a pattern match in the present with the original event, a 'flashback' may occur and we experience the trauma again, as though it is happening right now.  


Cognitive Behavioural Therapy, and EMDR, help the brain to process the traumatic event into a memory.  It is as if the process enables the incident to be filed away in the appropriate filing cabinet of our mind.  It then becomes a past event, rather than a reliving of the trauma as if it is happening right now.  

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QUIT DRINKING: "I decided to quit drinking for 'sober October'. So went to see Nicola. We had an in depth consultation and not only did I get through October without drinking. I now find I don't want to drink at all. I have been so pleased with the result and my life is getting better and better without Alcohol in it. I have recommended quite a few people now for different things. Thank you Nicola. " Clare