This month I thought I would explore the concept of the integrative counsellor approach. In brief that means, for me, working as a counsellor who has had training in more than one modality or therapy technique who combines those techniques to help the client achieve their therapy goals in the best way possible for the client.

An example of this would be to combine CBT, Mindfulness and Person Centred therapy together. In this example I am going to use anger and road-rage as it is one that is simple enough for most people to empathise with in some way.

Person A comes to therapy in order to deal with their anger, the therapist uses person centred talking skills to help the client feel safe, understood, accepted and cared for, allowing the client to open up about their understanding of their anger and their feelings about their anger, allowing the person to self-actualise and accept their issues. This is where the counsellor may then use the CBT triangle about thoughts, behaviours and feeling, exploring in these terms what the client has realised. That they are able to recognise the angry feeling, the thought behind that feeling and the behaviour they automatically associate with it. The therapist may then use the Mindfulness STOP technique to help the client recognise and alter the values in the CBT triangle thus assisting the client to change their behaviour.

For example Mindfulness:

S – Stop
T –  Take a breath, relax
O – Observe – I am feeling angry, I understand my thoughts behind my anger are X Y Z (found via previous person centred discussion).
P – I am choosing to proceed differently from my normal behaviour which would be shouting and beeping my horn, by replacing the fear and anger with calm, acceptance I am still safe and alive and anger is not helpful to me, or by singing (this technique can vary based on the client and the explorations made with the client in person centred discussion)

For example CBT Triangle:

                                                            Feeling – Anger/Fear

Behaviour – shouting, beeping horn                                        Thought – that person is rude, I nearly died

Thus in conclusion the therapist has used 3 different modalities to help the client achieve a deeper understanding of self and to adjust their behaviours in conjunction with this new understanding. This is just one very basically explained example and integrative therapy can be deeper and more complex that I have shown here, often using multiple modalities that are combined and sometimes difficult to separate as easily as I have here.

If you are struggling and would like intergrative support with mental health issues or you’d like video, telephone or face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304

I am not going to write a complex set of definitions for PTSD, it’s trigger, or it’s symptoms because they all exist written perfectly well at this website and I doubt I could do a better job than they have. So I am directing you to their website and offering you a very brief description of a complex conditions. https://www.ptsduk.org/what-is-ptsd/ptsd-explained/

PTSD can be caused by one specific incident or a continued exposure to a difficult environment. It does not have to be an incident or exposure that would impact on everyone because everyone processes trauma, memories and incidents differently (just because one person likes something doesn’t mean everyone will, and the same for PTSD, just because 1 person experiences the same as others doesn’t mean they will, at that time, process it the same way). The reason someone is processing differently or finds an event traumatic is something still being understood, it could be chemical or psycho-social or a combination.

PTSD is when the brain does not process experiences in its normal way. Normal being it takes in information, stores it briefly in pre frontal lobe (at the front of the brain) in the short term memory, then uses chemicals and processes like sleep to encode it and file it in the correct place, the hippocampus, and link it to other memory pathways using neurons, eg a memory of roses could be linked to the idea of lipstick or poppies because they were all red, often memoires have hundreds of links and ways of being accessed. However, with PTSD for whatever reason, this normal process has not occurred and these images and memories are not linked or stored as normal. They pop up with random connections, they float around and are too easily accessed, they bash into other images and give confusing incorrect memories, they interrupt sleep or thought processes, they barge into everyday life. However, because they are not processed properly they can feel very realistic and traumatic to the brain rather than feel like a normal memory. This means the brain can react as if it were in the original moment again, causing an adrenaline burst, fear, sweating, anxiety, tense muscles, heightened senses, increased heart rate and breathing among other things. Hence people with PTSD try to avoid certain things that can trigger these non-stable memories.

Therapy can sometimes help to normalise, analyse and understand these memories and events, allowing the brain to process them and thus reducing the triggers and the unwanted ‘false alarm’ response from the brain. There are also more in-depth treatments for PTSD and you should always seek a medical diagnosis and treatment from you GP if you think you have PTSD.

If you’d like video, telephone or face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304

Today I thought I would write about something that I have found myself discussing on an all too frequent basis in the last few weeks at home and at work. This is the topic of resilience. I am currently very aware that many peoples resilience is at an all-time low, and I feel that this resilience depletion is in the most part due to the following set of circumstances.

Mostly and primarily due to the pandemic and its ongoing cost to human life and normal human activity, and while I know this to be mostly true for our little island of UK, I can only make an educated guess that this is probably something that is all too true for many nations, communities and individuals across the world currently.  This invisible killer, a threat to our freedom to socialize, a risk to our long term health and our loved ones that we cannot hide from, we cannot physically fight off, we cannot run away on holiday from, that is in the back of our minds, and our subconscious fears even when we don’t want it to be. We cannot do anything to be free and peaceful while the pandemic rumbles on. Now this is very acceptable that we have these fears and take precautions, that we have vaccines and we isolate, that we take tests and reduce our activities but after 2 years of being on constant alert to an invisible enemy, being lonely, fearful, exhausted, it takes its toll on the strongest of us. It is unprecedented, even if we compare it to war, in war there is hope of running to another country where there is peace.

If we add this constant fear and life changing behaviors that in this northern hemisphere we are currently in the dark and cold winter months, the big festivals of light, happiness and joy have just passed and people are natural low at this time of year anyway, we have limited hopes for those summer vacations (will they be canceled, dare we go, will we be stranded, will we have extra tests or costs, etc), many are still on reduced income or have been made redundant unable to look forward to the usual summer festivities or hopes, festivals and gatherings are at a low, sometimes it feels that everyone knows someone who has tested positive for COVID recently and you worry that even meeting friends could mean infection, isolation, life disruption, worry about how ill you might be.

If all this is true then it is easy to understand the resilience we have after 2 years of this fight is somewhat depleted and waning. Now if you feel low just reading this imagine what your subconscious feels living with it every day and that you are still trying to find hope and positivity in the small things, that you are smiling and functioning says so much about your strength. And if you feel you are not functioning then I also commend you for being able to recognise your limits. Take a break and forgive yourself.  I have no magic answer to where to find more resilience, but I do hope that the recognition that this is normal and that it is not just you should go a little way to helping you feel somewhat more OK.

These are just my musings on the topic and are by no means infallible or the authority on the subject, and I encourage everyone to explore their own understanding of their feelings, but I hope they may have some positive or helpful impact in your life.

If you are struggling and would like support with mental health issues or you’d like video, telephone or face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304

I was chatting with a friend the other day and they mentioned how hard they find it to love themselves. Later the same day this song came on the radio as I was driving home from my office, the words seemed very pertinent to the conversation I’d had earlier that day. I thought I’d share them with you.

“Everybody searching for a hero
People need someone to look up to
I never found anyone who fulfill my needs
A lonely place to be
And so I learned to depend on me

I decided long ago
Never to walk in anyone’s shadows
If I fail, if I succeed
At least I’ll live as I believe
No matter what they take from me
They can’t take away my dignity

Because the greatest love of all
Is happening to me
I found the greatest love of all
Inside of me
The greatest love of all
Is easy to achieve
Learning to love yourself
It is the greatest love of all”

The song is probably most famously performed by Whitney Houston and was written by Michael Masser and Linda Creed.

It talks about finding out that loving yourself gives you a sense of pride and achievement and the strength to face life’s challenges. It means that you don’t necessarily need others to love and validate you as you love yourself and are worthy just by being you. Why not look inside yourself and see how wonderful you are, learn to use your personality to achieve the best you can, which is good enough and all we need.

If you are struggling with liking yourself, would like support with mental health issues or you’d like video, telephone or face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304

Again a celebration for some but not for others (please see previous post). I just want to say to everyone a key sentence:

Do it your way.

Don’t make a resolution if you don’t want to, don’t drink excessively if you don’t want to, don’t party all night if you don’t want to. OR Do make a resolution if you do want to, do drink excessively if you do want to, do party all night if you do want to. Just make sure you do it your way, big and bold, quiet and comfy, family, friends or alone, whatever is right for you.

I just also want to say a little somethings I’ve noticed about resolutions. Sometimes it helps to stick to things if you take small steps towards the goal rather than rushing head on at full speed. For example if you want to run 10km start by running 500meters, then run 1km, then run 1.5km. If you want to lose a few stone in weight, start small by aiming for just 1lbs a week, it soon adds up, you feel achievement and success as you go and hopefully you will be more likely to reach your goal.

Whatever you choose to do, I wish you hope for the future.

If you would like support with mental health issues or you’d like video, telephone or face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304

This time of year is usually full of celebration with family, with happiness and life. This can be overwhelming for people with anxiety or depression, it can cause uncomfortableness for people with OCD or spectrum diagnosis, it can reopen bereavement wounds believed to be healed to name but a few.

I would like to share a version of Yule that I find comforting. And at the end I will also share some local support numbers for those of you in need, or if you know someone who may benefit from them.

Yule historically has been about life, and light in the darkness, about making it through the cold, long winter and welcoming spring. About the hope of survival and the future. This is why lights on trees and wreaths are lit and yule logs are burnt, why evergreen boughs are brought into the home and people feast and spend time with family. These are representations of hope and future. Maybe this version of the winter feast will make a connection with you? To help you fight through the darkness, whether it be darkness caused depression, anxiety or bereavement, maybe you can hope for the future, hold a light until the darkness fades, have hope for new life by enjoying the green leaves of the holly and fir trees.

If you are struggling at this time of year and if I am closed or it is the holidays here are some numbers and websites that may help:

Samaritans – 116123   https://www.samaritans.org/

Accesss Team – 03001230907

Childline – 0800 1111 childline.org.uk

Staffordshire Mental Health Helpline –  0808 800 2234 

And remember if in doubt call 999 for immediate support

If you would like support with mental health issues or you’d like video, telephone or face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304

A phobia is an extreme, persistent, overwhelming, debilitating or irrational fear or aversion to something such as a place, object, situation, animal, medical treatment or feeling. It is much more intense than a fear response and can in some case be classed as an anxiety disorder. It is also a persistent event that can reoccur. A phobia can lead to a restricted behaviour pattern to avoid the phobia and have a significant impact on someone’s life, home, job and activates.

Symptoms may include:

• dizziness and light-headedness
• nausea
• sweating
• increased heart rate/palpitations
• chest pain
• chocking
• shortness of breath or gasping
• trembling or shaking
• an upset stomach
• feelings of unreality
• preoccupied with the fear object
• numbness
• out of control
• detached
• overwhelmed

There are many types of phobia but often they fall into 2 categories: specific/simple phobias based on one object or situation – like spiders, or complex phobias – like agoraphobia. Simple/specific phobias often (not always) stem from childhood and adolescence. Complex phobias are more often associated with adult trauma or fear.  

Some examples of specific phobias are: animal phobias – dogs, spiders, snakes; natural environment phobias – heights, water, darkness, germs; situational phobias – flying, the dentist, small spaces or escalators; sexual phobias – sexual acts, fear of STI’s; body-based phobias – blood, vomit/vomiting, needles, choking, medical procedures, childbirth; other phobias can also include foods, objects or costumed characters. Some examples of complex phobias are agoraphobia, social phobia.

Phobias do not have a single or simple cause, there can be a number of associated factors such as association with a traumatic event,  learned response from childhood or watching someone else’s response, a genetic component can also be evidenced, some scholars have even suggested humans can have primal fear responses like those to dark or fire.

What happens in the brain in a phobia reaction? Those areas of the brain that store and recall dangerous or potentially deadly events are triggered by something (spider/height etc) causing to the body to have an inappropriate stress reaction to the object/event. This is because phobias are often linked to the amygdala which lies behind the pituitary gland in the brain, the amygdala triggers the release of fight, flight, freeze hormone reaction.

Phobias are not usually formally diagnosed as most people with a phobia are fully aware of the problem and do not need a medical diagnosis, you already know if you scream at a spider. People often choose to live with their phobia especially if it is something both avoidable and unavoidable like heights or spiders. Others, usually those with complex phobias, may find their phobia debilitating and seek medical/professional help

It has been suggested that almost all phobias can be successfully treated and cured. Simple phobias can be treated with exposure therapy through gradual exposure to the object, animal, place or situation that causes fear and anxiety. Or hypnotherapy can help with simple phobias to alter subconscious beliefs and reactions. Mindfulness can help with relaxation and reduce impact of symptoms. Treating complex phobias often takes longer and involves talking therapies, such counselling, psychotherapy, CBT (identify link between feeling and behaviour and alter this pattern), medication (antidepressants, beta blockers and tranquilisers).

If you are struggling with phobias, would like support with mental health issues or you’d like video, telephone or face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304

Let us start with how people describe feeling during a panic attack (this is not an exhaustive list):

• Rapid heart beat
• Sweating
• Chest pain
• Trembling or fidgeting limbs
• Shortness of breath
• Nausea
• Abdominal cramping
• Headaches
• Dizziness or faintness
• Blurred vision
• Numbness or tingling sensation
• unreality or detachment
• Loss of control.
• Sense of impending death or danger

Why do we react like this? Well when something triggers a panic attack our bodies fall back to their primal response, you may have heard it called fight, flight or freeze. This releases chemicals such as adrenaline and cortisol into the body so we are ready to react to whatever the body has perceived as a threat. However, without any threat to react to the body now needs to do something with this flood of unneeded chemical. This causes the symptoms of rapid breathing, sweating, swimming head, tense tummy, rapid heart rate, twitching muscles because the adrenaline and cortisol that tensed muscles and increased heartrate and breathing to run or fight now has muscles that aren’t running or fighting. Thus we are left with adrenaline and other chemical flooding the body causing a reaction with nothing to use them up.

What causes a panic? This is a harder question to answer as the usual answer is something very unique to the person experiencing the panic attack but it can be any number of things such as a trigger (a colour, a sound, a scent, etc), it can be a reaction to a memory or thought process, it can be an upcoming stressful event. Sometimes however, people have no idea what has triggered their panic attack which can make it harder to help avoid causes.

How can we help ourselves? There are several options to help panic attacks. Some medications can offer relief from them – speak to your doctor about these if you feel you need to. Sometimes people find moving around helps to use up the chemicals in their body. Some people find focusing on a calming object such as a pebble, using their senses to focus on the item. Some people find focusing and controlling their breathing helps. Some people find reciting poetry or song lyrics helps them. Some people like sounds or scents to help them focus. Some people count to help themselves. Again the best solution is often as unique as the trigger because each and every one of us is individual in our experiences.

If you are struggling with panic attacks, would like support with mental health issues or you’d like video, telephone or face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304

I was going to try to type out all the information I had about personality disorders, then I remembered that I have a wonderful factsheet prepared by Rethink Mental Illness. So I decided to share that with you all and offer only a very brief description of a personality disorder so that you can focus on the wonderful work they have already done.

FACTSHEET

What is a personality disorder? This is when a person thinks, behaves, acts, feels or responds/relates to other people differently to the majority of the population. Each type of personality disorder is different and they symptoms differ due to each disorder as the factsheet explains in detail. Some people with personality disorders can struggle with depression and anxiety, as well as other mental health difficulties.

Mind have also got a really helpful page on Personality Disorders.

Although I am by no means and experts in personality disorders if you would like support with mental health issues or you’d like video, telephone or face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304

Depression is a mood disorder. Often a PHQ 9 questionnaire is used to help diagnose depression. People can experience depression over a few weeks or months, over a few years or all their life. They may have one episode or repeating episodes throughout their life.  Depression is more than a feeling of ‘fed up’ or ‘miserable’ for a few days as this is a very normal experience for most people to have short periods of low mood. To be diagnosed as clinical depression these feelings of persistent and lasting sadness, hopelessness and unhappiness have to last for weeks or more and are bad enough to significantly disrupt normal functions of your work, social life and family life (doctors sometimes categorise it with mild, moderate and severe labels).

One big question often asked regarding the causes is Genetic/Physical or Life Experience? It is a difficult question to answer. Brain chemistry of depression involving the role of neurotransmitters and chemicals like serotonin and norepinephrine, hormones such as thyroxine can be involved. Some research has shown people with depression have slight physical difference in their brain structure as well. Often people who have family members with depression are more prone to depression, but psychologists and scientists are not sure if this is nature (genetics) or nurture (watching and mimicking someone as you grow up).

Some people like to separate depression into types, you may have heard of SAD or Seasonal affective disorder a type of depression that occurs at a particular time of year – usually autumn/winter. Dysthymia a continuous mild depression lasting for two years or more (sometimes called persistent depressive disorder). Prenatal depression (during pregnancy) and Postnatal depression (first year or so after giving birth). Some people class grief as a type of depression, I personally see them as different yet having some similarities based on my experiences having worked as a bereavement specialist, and with people who are depressed.

Depression can be a part of other mental health problems, such as bipolar disorder, borderline personality disorder, other personality disorders and schizoaffective disorder to name a few.

Symptoms of depression include feeling unhappy or hopeless, low self-esteem and finding no pleasure in things you usually enjoy. Depression can have psychological, physical and social symptoms continuous low mood or sadness. These include feeling (not an exhaustive list):

•          hopeless, pessimistic or helpless

•          low self-esteem

•          tearful

•          guilt-ridden or worthless

•          irritable and intolerant of others cranky and restless

•          having no motivation or interest in things

•          finding it difficult to make decisions

•          not getting any enjoyment or pleasure out of things you normally would

•          anxious or worried

•          suicidal thoughts or self-harming

•          struggling to focus or remember

•          moving or speaking more slowly or more quickly than usual

•          changes in appetite (eating more or less) or weight (gain or loss)

•          constipation

•          unexplained aches and pains

•          lack of energy

•          low sex drive

•          changes to your menstrual cycle

•          disturbed sleep – difficulty falling asleep at night or waking up very early, trouble staying asleep

•          tired or lacking energy

•          avoiding contact with friends and taking part in fewer social activities

•          neglecting your hobbies and interests

•          having difficulties in your home, work or family life

•          digestive problems

•          “empty” feelings

•          a sense of unreality

•          using more tobacco, alcohol or other drugs than usual

•          delusions, such as paranoia

•          hallucinations, such as hearing voices.

There is no single or unique agreed cause of depression. It is believed depression can occur for a variety of reasons and it has many potential and different triggers. It can be one event or a collection of events, it may even be linked to an illness. Some of these ‘causes’ can include:

•          Personality /Family history – certain personality traits may make people more vulnerable to feeling depression, possibly due to genetics, or your early life experiences, or both.

•          Giving birth – hormonal and physical changes, as well as new responsibility could possibly trigger pre/postnatal depression.

•          Loneliness – sometimes caused by feeling low and stressful events/occurrences leading us to isolate from friends and family perpetrating the depression.

•          Alcohol and drugs – drugs such as cannabis can trigger depression, particularly in teenagers, while alcohol affects the chemistry of the brain, which increases the risk of depression (please see previous blog posts about drugs and alcohol).

•          Illness – evidence shows there is a potential higher risk of depression if you have a longstanding or life-threatening illness, such as coronary heart disease, cancer, underactive thyroid (hypothyroidism), or damaged pituitary gland, or if you suffer a head injury they can sometimes trigger mood swings and emotional problems. A chemical imbalance or hormone issue, conditions affecting the brain and nervous system, menstrual cycle or the menopause, low blood sugar.

•          Childhood experiences – physical, sexual or emotional abuse, neglect, bereavement, traumatic events, an unstable family situation, bullying

•          Low self-esteem – how you learned to cope with difficult emotions and situations can make you feel less able to cope with life’s ups and downs and lead to failing coping mechanisms.

•          Life events – such as losing your job or unemployment; the end of a relationship; bereavement; major life changes, like changing job, moving house or getting married; being physically or sexually assaulted; being bullied or abused; trauma; illness. It takes time for people to come to terms with events, such as these. If these happen consecutively some people may feel they spiral into depression.

•          Sleep problems, a poor diet, lack of exercise can also lead to depression and altered body chemistry.

•          Other mental health problems and illness such as anxiety; eating problems; PTSD; bi-polar; personality disorders.

Treatment for depression usually involves a combination of lifestyle changes, talking therapies and medicines such as SSRI commonly known as anti-depressants (please see earlier blog post about medications for more information). A good place to start would be your doctor or speaking to a therapist.

If you are struggling with depression or would like support with mental health issues or you’d like video, telephone or face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304