EVIDENCE BASED TREATMENT

My approach to therapy

The heart of my work is based in Cognitive Behavioural Therapy (CBT), which is a therapeutic approach that is evidence based and its the gold-standard treatment for the most common psychological issues such as anxiety and depression. My approach also includes Acceptance and Commitment Therapy (ACT), Schema Therapy , Assertiveness Therapy, Attachment based approaches and mindfulness-based approaches. For me, it's important that individual therapy includes treatment tailored to your particular needs. I'd like to offer you a space to gain whatever it is you need and are searching for and to achieve your therapeutic goals.

Duration of treatment

Most people have bi weekly sessions, but more frequent or less regular sessions are also possible, and just as effective long term. Session length is 50 mins. Most of the treatment modalities I use have been shown to be effective over a short period of time, with an average length of around 10-12 weekly sessions. That being said, depending on your needs, or what you are looking for, the therapy period can be shorter or longer.

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ANXIETY

Anxiety can add daily life difficulties. Around 30% of people experience clinical levels of anxiety at some point in their lifetime. Some of the common symptoms of anxiety include :

Constantly worrying about things
Feeling restless or 'wired'
Difficulty concentrating
Inability to relax
Difficulty sleeping
Burn-out, exhaustion, break-down
Muscle tension, racing heart, dry mouth
Panic attacks
Avoiding important things, such as social events, work events, etc...
Feeling impatient

Anxiety also tends to be involved in Obsessive-Compulsive Disorder (OCD), in which an unwanted thought (obsession) needs to neutralised with a behaviour (compulsion). A typical example is needing to check the front door over and over again – even when you know it's locked.

Anxiety also plays a role in phobias.

But while anxiety, OCD and phobia are common and, fortunately, among the most readily treatable mental disorders. Therapies such as CBT and ACT have great results in terms of reducing symptoms. I am interested in listening to your story and helping you manage your anxiety symptoms with new healthy strategies.

DEPRESSION

Everyone can have low moments. But when this drags out over a long period of time, is extremely intense, or begins to create a feeling of hopelessness, then it could be time to seek help.

It could be that you find it an effort to do things you’d normally find easy, or notice you’re doing less of things you normally enjoy such as leisure activities, seeing friends or exercising. You may also feel guilty about not performing as well as you typically do, or maybe even feel like you’re beyond caring.

In some cases, the causes of depression are obvious, but it can be common that we have don't know how we went from feeling OK to feeling sad and hopeless.

Common depression symptoms include :

Lacking motivation and energy
Not enjoying things the way you used to
Not feeling good about yourself
Feeling sad, crying
Having thoughts of death or dying
Wondering what the point of anything is
Not feeling good about the future
Becoming easily irritable
Being more tired than usual
Sleeping or eating too little, or too much
Numbing feelings with alcohol, drugs or sex

I’m interested in helping you understand how you got to this place, and then help you find a way through (and to manage the negativity). We can put in place some new strategies to maintain emotional well being and prevent future depression bouts.

RELATIONSHIP DIFFICULTIES

It is a human need to connect with others and to flourish in warm, intimate relationships. However single individuals and couples often could benefit from help understanding certain patterns in the way they connect with significant others, or how to achieve the kind of relationship they are searching for. Relationship counselling can help make sense of things such as:

frequent arguments and conflicts
not feeling heard or appreciated
trouble finding a suitable partner
difficulty asserting yourself
growing apart in a relationships
communication breakdowns
differing views on raising children
not knowing whether to stay in relationship
coping with break-ups

For couples, a an important step is to focus on working on communication skills and listening in an open and non-judgemental way. Oftentimes, two people can love each other deeply without understanding one another deeply. A person who is single could also need help understanding what kind of relationship will really meet their needs and is in line with their values. Relationships are crucial for emotional wellbeing, and it is important to cultivate them with the care and attention they deserve. Therapy is a way to do this.

STRESS AND WORK ISSUES

This can include longer working hours, greater job demands, more complex tasks, the ability to be constantly on call, difficulties between colleagues...

High levels of stress are an everyday experience for most people. Stress can be overwhelming and if left unattended can become to feel unmanageable.

Working on stress can involve many different therapeutic methods. This might involve problem-solving how to maximise your resources. This also involves recognising which situations are stress triggering, and optimising your responses to them. These strategies can be beneficial work towards reducing your stress levels.

Methods such as mindfulness and relaxation and optimising diet and exercise can be beneficial as well. It's also crucial to give yourself moments away from work, to help recharge your battery.

By examining stress from a variety of angles, you can work on feeling more calm and boost your quality of life overall.

ANGER MANAGEMENT

Anger can be at the root of a lot of personal and interpersonal harm. However, it is often not acknowledged nor spoke of. People who have difficulties regulating their anger can struggle to maintain harmonious relationships with those around them. This can lead them to feel lonely and misunderstood.

Of course, it’s only human to get angry sometimes. However anger might start to present difficulties for you if the following symptoms are present :

Consistent conflicts in close relationships
Angry behaviour (e.g., shouting) even when it’s counterproductive
Difficulty with negotiating or reaching agreements without getting angry
Difficulty to maintain relationships with colleagues
Reoccurent thoughts of being treated unfairly
Physical violence and/ or breaking things
Holding grudges
Becoming especially angry or aggressive when drinking
Ignoring people/refusing to speak with them
Frequent thoughts of how to get revenge

Anger can be an emotion that you were exposed to growing up. It's possible to have had a parent/care taker who was angry a lot. Through learned cognitions and behaviour this may make it seem impossible to be heard and respected without getting angry. It may make you feel that if you aren't this way, you'll be a "pushover." However, the person who can be pushed around and hurt by anger is the person experiencing it.

CBT for anger offers effective coping strategies which focus on getting your needs met, while being able to stay cool and collected. This sort of work focuses on teaching you that there are ways of being strong and assertive, without resorting to anger and angry behaviour. These methods can also lead to happier and healthier relationships, as well as more harmony within yourself.

TRAUMA RECOVERY

It can happen that bad things can happen to us, and sometimes we are left with this feeling that it just seems impossible to just get over. Personal tragedies, natural disasters, violence and other disturbing events can have a detrimental effect on our emotional balance and leave us feeling scared and helpless.

If you’ve experienced an event that’s left you feeling in constant distress, you may be experiencing symptoms of trauma. In some cases, such as those who are experiencing Post-Traumatic Stress Disorder (PTSD), there can be a persistent sense of danger and painful instrusive memories. If you are experiencing some of the following symptoms, it may be time to seek help :

Trouble functioning at home or work
Scary memories, nightmares, or flashbacks
Panic, anxiety, or depression
Emotional numbness and disconnection from others
Difficulty forming close, satisfying relationships
Avoidance of anything that reminds you of the trauma
Using alcohol or drugs to feel better

At the moment, everything might feel so overwhelming. It's important to remember that this is a natural response to trauma. While there can be moments where you may feel like you’ll never get over what has happened to you, there are effective ways to work on healing and moving forward, whether the trauma occurred recently or a long time ago.

Therapy and different techniques can help you manage negative emotions, reduce the intensity of painful memories, and progressively move past the trauma and towards a happy and healthy life.

SELF ESTEEM ISSUES

People experiencing low-self worth feel less capable to manage life’s challenges, stand up for themselves, feel comfortable in relationships, and are more susceptible to anxiety and depression. Low self-worth can often begin in childhood. This could involve an upbringing that was invalidating or negative averse events during childhood, which could have left you with a sense of not feeling good enough. Or it is possible that you have found it difficult to live up to other people's expectations, or the pressure you put on yourself. If you have low self-esteem, you could be experiencing the following :

Feeling unlovable, awkward or incompetent
Feeling you need to be, or look, perfect to be accepted
Avoiding social situations with unfamiliar people
On the look out for signs of rejection
Avoiding new or challenging things
Relentless inner-criticism, e.g., calling yourself ‘stupid’ or ‘ugly’
Not opening up in relationships
Difficulty asserting yourself and saying no

The costs of having all of these thoughts and behaviours is that you can feel overburdened, resentful, anxious and depressed. Therapy allow you to re-examine the negative beliefs you have about yourself and take a look into the coping strategies you have formed in order to deal with these beliefs. Therapy also allows you to recognise your positive qualities, build positive relationships, be more assertive with others and also kinder to yourself.

PROCRASTINATION DIFFICULTIES

Procrastination is not typically something we plan, nor want to do. However, the habit of putting off what's important to us, and instead engaging in what's easy/comforting can form unhealthy patterns which can leave you feeling unable to cope. It can be difficult to know when this maybe an issue for you, because almost everyone struggles to get things done from time to time. If procrastination may be an issue for you, you could be experiencing some of the following :

You're failing to meet work or study deadlines
The quality of your work is affected
Your productivity has decreased relative to your normal levels
It’s causing problems at work, at school or at home
You’re struggling to keep up other responsibilities
Your relationships may be beginning to suffer
Your time management problems lead to sacrificing activities you enjoy
Your friends and family are concerned about you

Therapy can help you recognise the emotions, thoughts and situations that feed/trigger procrastination, and help you identify and work on certain habits. It’s also essential to work on any underlying issues, such as anxiety or depression, which might make it hard to stay focused on tasks.

HANDLING A LIFE CRISIS

When confronted with a huge life change, even emotionally stable individuals can be thrown for a loop. Illness, relationship breakdowns, financial crises, the death of loved ones... Life can affect our wellbeing in certain moments, even if we didn't plan for it. It can even be many small stressors all happening at once, cumulatively creating difficulty. Of course, everyone goes through difficult times, but you don't need to suffer alone.

With a trained therapist, you can have someone who will listen, understand, and try to help you find a way through these difficult times. While therapy is unlikely to resolve everything that's going on in the world around you, the beauty is that it can change the way in which you respond to events, and give you strategies to do so, developing your resiliency. This is the learned ability to adapt in a healthy way to times of adversity, trauma, tragedy, and threats or stress. Resilience is about being able to handle events calmly, and bounce back after they've occured. And it's a skill that you can develop in order to help you deal with life's curveballs, learn from them, and come out on the otherwise happier.

INSOMNIA

Living with insomnia can be challenging. Luckily, effective treatments are available that can help you fall asleep faster, stay asleep, and feel more rested and functional during the day.

Therapy for insomnia focuses on exploring the interconnection between the way we think, the things we do, our feelings and how we sleep. This helps determine what could be contributing to the symptoms of insomnia.

You could be exerperiencing clinical insomnia if you have some of the following :

Difficulty falling asleep at night
Waking up during the night
Waking up too early
Not feeling well-rested after a night's sleep
Daytime tiredness or sleepiness
Irritability, depression or anxiety
Difficulty paying attention, focusing on tasks or remembering
Increased errors or accidents
Ongoing worries about sleep

It may be time to seek help if insomnia makes it hard for you to function during the day.

Therapy for insomnia is a multicomponent approach because it combines several different approaches. I'm interested in giving you cognitive, behavioural, and educational components, in order for you to sleep and function better during the day. It’s also important to work on any underlying issues, such as anxiety or depression, which might be contributing to the insomnia.

PERFECTIONISM

It can be tiring feeling like you need to be perfect all the time. And it can actually start to feel like an endless cycle as we continue to set more and more unrelenting standards.

Perfectionism typically involves three things: First, the relentless striving for extremely high standards for yourself and/or others that are extremely demanding of oneself. Second, judging your self-worth based in large part upon on your ability to strive for and achieve such unrelenting standards. Third, experiencing negative consequences of setting such demanding standards, and yet continuing to reach for them despite the huge cost to you and your wellbeing.

I'd like to help give you new strategies, in order to decrease the perfectionist behaviour, and help you encourage kindness and self compassion.

ADDICTIVE BEHAVIOURS

A substance use disorder (SUD) involves patterns of symptoms caused by using a substance that an individual continues taking despite its negative effects despite its negative effects.

Criteria for diagnosing addiction include :

Tolerance
Withdrawal
Hazardous use
Social/interpersonal problems related to use
Neglected major roles to use
Used larger amounts/ longer
Repeated attempts to quit/control use
Much time spent using
Physical/psychological problems related to use
Activities given up in order to use the substance

Addictive behaviours can touch every aspect of our lives slowly over time. This can feel like a never ending cycle and it can be challenging to see a way out. Effective treatments are available to treat addictive behaviours, notably wonderful methods from CBT, that help individuals transform their thoughts and replace unhealthy coping strategies with healthy ones.