What I can help with

Anxiety is a normal human response to threat and we all need some anxiety to function in the world. In evolutionary terms, that threat might have come from predators, or from running out of food. There would have been social anxiety too – making sure we were accepted by a group in order to survive. These days, feelings of threat tend to be more abstract – whether we are ‘good enough’, worrying that we are letting down our loved ones, or whether we are up to the role at work. Our minds, having evolved to deal with different kinds of threat, aren’t always adapted to deal well with these problems. Our attempts to get rid of these feelings can often end up making things worse.

Anxiety can lead to a variety of problems, from avoidance to sleeplessness to alcohol abuse, as we struggle to deal with its effects. However, perhaps the most common anxiety problem seen by therapists is overthinking. We might try to anticipate everything that could go wrong, perhaps as a way of feeling prepared. Or we might try to reassure ourselves that everything will work out (unfortunately, the mind will usually have one more, ‘But what if…?’) There can be different reasons for this – we might be over-perfectionistic, have negative beliefs about our capacity to cope, or we might need to develop skills to better tolerate anxious feelings.

Cognitive Behavioural Therapy (CBT) or Acceptance and Commitment Therapy (ACT) offer highly effective strategies to understand and better manage anxiety. Some forms of anxiety require specific approaches – eg Generalised Anxiety Disorder, Obsessive Compulsive Disorder or Post Traumatic Stress Disorder – but most forms of anxiety can be tackled with conventional therapies.

Depression can be a difficult thing to pin down. Some sadness or low mood may be part of the human condition – which is why it has been difficult to identify genes for depression, for example. Some depressive tendencies may run in families, ‘genetic loading’, or it may be linked to early losses or difficult life experiences. Hormonal factors can be at work – about ten or fifteen percent of new mothers may be affected by post-natal depression, for example. Mood can even be affected by the weather – e.g. Seasonal Affective Disorder, where lack of sunlight may disrupt serotonin levels.

Fortunately, contemporary psychological therapies have been shown to help. These emphasise how thoughts, mood and behaviours are always in relationship to each other. Low mood might cause us to have negative thoughts and withdraw, which in turn might make us feel more depressed, a sort of vicious circle. Certain patterns of thinking are probably also at work – catastrophizing (problems are experienced as overwhelming), mental filtering (only seeing difficulties and not our capabilities), or emotional reasoning (I feel it, so it must be true). Other thought processes like rumination (endlessly chewing over things) may be the mind’s attempts to understand something, but ultimately it may end up trapping us with our problems.

Therapy involves getting behind some of these maladaptive patterns and trying to understand our situation – and how we might move forward –  in a more constructive way. It may involve identifying some negative automatic thinking, or some hidden core beliefs about ourselves. The process is not always easy, but the gains can be transformative.

Relationships should be where we find love and fulfilment, but, when things start to go wrong, they can quickly turn into battle zones. One partner can become sensitised to the other’s behaviour, the other feels pressurised, and the stage is set for action-reaction type conflicts. We might hear telling phrases being flung at each other, ‘This is you all over!’, ‘Why do you always do this?’ which are more about patterns of conflict, and less to do with the actual thing the couple are meant to be arguing about.  

However, step back and, underneath the battling, it might be that the feeling for each other is still there, but just lost in all the antagonism and conflict. There may be more vulnerable emotions sitting just underneath all the anger. Someone might feel unheard, or devalued, or that the other person has lost interest in them. Understanding this can then allow engagement with patterns in a more constructive way. Often there is a way back to a happier relationship.

Relationships can be looked at in both individual and couples therapy. Individual therapy would involve looking at these patterns from the individual’s point of view. There may be hidden self-defeating behaviours at work – perhaps fear of commitment, or intimacy, or of getting close and then being abandoned. Or there may be family patterns that re-emerge, perhaps hidden feelings that relationships can’t work, or can bring distress or just aren’t worth all the aggravation. Some of these things are difficult to spot when you are close to them which is where therapy might help.

Understanding relationship dynamics enables people to make different choices about their relationships, rather than being entangled in behaviours which they may find difficult to see in themselves. There is then the possibility of new ways forward.