Agoraphobia

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.

Anger Management

Most people experience short term irritability, frustration and annoyance, when their values, rules or standards are threatened or broken. 

However, an anger disorder usually develops from failing to address underlying anger problems.  Over time the angry feelings can develop into feelings of resentment, bitterness, hatred and rage.  This can then have a damaging effect on physical health, relationships and work.

Common factors in anger include:

• Black and white thinking
• Increased heart rate, rapid breathing, muscle tension, stomach problems and headaches.
• Seeing malicious intent in the motives of others 
• Plotting revenge
• Feelings of distress, guilt, and shame following anger episodes.
• Physical and verbal aggression.
• Passive aggression

Anger is not primarily about aggression. It usually starts with a distressed reaction to a sense of having been "wronged" in some way. 

Negative Experience - Distressed Feeling - Sense of being Wronged - Anger - Counter-attack.

CBT for Anger Management

CBT offers a range of cognitive and behavioural techniques to effectively manage anger. It involves identifying, testing and altering the beliefs, rules and assumptions that maintain the anger, as well as changing some of the learnt behavioural responses to anger provoking situations and triggers.

Anxiety

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.

The basic premise of CBT is that our thoughts, not the events themselves, affect the way we feel. The way you think about the situation, often stemming from past experiences, affects how you feel. 

Depression

Clinical research has shown CBT to be an effective treatment for depression.

CBT looks at a person's mood in relation to thought patterns. Negative, unhelpful thinking affects a person's mood, sense of self, behaviour, and even physical state. The goal of Cognitive Behavioral Therapy is to learn to recognize negative patterns of thought, challenge them and replace them with healthier new ways of thinking.

CBT also looks at changing patterns of behaviour that result from unhelpful thinking. Negative thoughts and behaviour make an individual more prone to depression and when patterns of thought and behaviour are changed, the mood starts to lift.

IBS

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 and hypnosis, can have very a beneficial impact on IBS.

CBT for 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 suggestion to help reduce symptoms and create helpful coping strategies.

For more about hypnotherapy see http://hypnotherapykingston.com

Low Self-Esteem

Low self-esteem tends to occurs when a person makes a demand on himself or herself, others or the world that is not met and then puts themselves down in some way.

The following are examples of themes that are commonly involved in low self-esteem. People can react to them as if they are true, whether they are or not.

Failing to achieve an important target or goal
Acting incompetently (in public or private)
Falling short of one’s ideal
Failing to live up to one’s standards
Breaking one’s ethical code
Being criticised
Being ridiculed
Not being accepted, approved, appreciated or loved by significant others

At Psychotherapy Kingston, I use CBT techniques to help the person form healthier beliefs about themselves, others and the world leading to self-acceptance and a healthier way of behaving and feeling.

OCD

OCD creates an increase in anxiety following an intrusive thought, whilst a normal response to an anxiety provoking situation is for the anxiety to slowly reduce after the initial event.  For someone with OCD the anxiety is maintained and often increases, usually because of their overestimation of the perceived level of threat.

CBT for OCD

Cognitive Behavioural Therapy (CBT) has been found to be the most effective treatment in successfully tackling Obsessive-Compulsive Disorder (OCD).  The aim of this approach is to enable the person to become their own therapist and to provide them with the knowledge and tools to continue working towards complete recovery from OCD. It remains the treatment of choice for tackling OCD by the National Institute for Health and Clinical Excellence (NICE) and specialist centres such as the Centre for Anxiety Disorders and Trauma (CADAT).

At Psychotherapy Kingston, I have found that In many cases, CBT alone is highly effective in treating OCD.  Also I find that techniques from Mindfulness, ACT and Hypnotherapy can enhance the process (see Supporting Therapies).

The aim of CBT is not about learning not to have these thoughts in the first place because intrusive thoughts cannot be avoided.  Instead it is about helping a person with OCD to identify and modify their thought patterns that cause the anxiety, distress and compulsive behaviours.

Therapy teaches the person with OCD that it’s not the thoughts themselves that are the problem; it’s what the person makes of those thoughts, and how they respond to them, that is the key to recovery from OCD.

Pain Relief

Pain has a purpose when it relates to a new injury or problem. It gives us the urgency to deal with an issue, relevant to how much of a problem it is. However, once we have had a proper medical diagnosis and the tissues are healed, or will never heal, and no more can be done except pain relief, that's when OldPain2Go can help - even when nothing else can!

Our bodies are miracles of nature and in most cases they heal themselves with no conscious input from us. It is this aspect of the mind that OldPain2Go taps into. OldPain2Go does it in a totally unique way - it gets the unconscious and conscious aspects to talk to each other with the practitioner as an intermediary. This is not like anything else and all a qualified practitioner needs to do is talk to you - it is not hypnosis - no trance is needed.  It is a simple methodology based on how the brain processes things, so whilst we all store different information in our head we do tend to process things in the same way as everyone else.

When we continue in pain, long after the initial warning it gave is unnecessary, then all we need to do is change that old, useless out of date program. This can be done at the level of the unconscious and I will guide you each step of the way to get you as pain free as is possible.

See OldPain2Go.

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.

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.

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.

Social Phobia

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.

CBT for Social Phobia

Cognitive Behavioural Therapy looks at the cycle of Sociap 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.

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.

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.  

CBT for PTSD

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.  

Weight Problems

CBT can be more effective than diet and exercise regimes on their own because it addresses the underlying core issues which fuel the gain/loss cycles. By treating the underlying causes of these patterns, clients are less prone to relapse.

Core issues may be related to self-esteem, social anxiety, faulty strategies for coping with stress and self-image problems.

CBT for Weight Loss

CBT focuses on changing how you think about yourself, how you act, and circumstances that surround how you act.  Strategies such as goal setting, self-monitoring, feedback and reinforcement, belief change and incentives are used to give you back control.

 

For help with nutrition and diet advice, contact my colleague, Kathleen Farren at www.KFNutritionCoaching.com 

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