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My Services

I do have some experience of working with children but as I am not specifically trained to work in CBT with children I prefer to stick to Adults and Young People aged over 16.  I am trained to work with a range of disorders including OCD, Depression and Phobia and I have a particular interest and skills in working with the following areas:

  • Social Anxiety (Suggested Reading)

  • Low Self Esteem (Suggested Reading)

  • Panic attacks (and Limited Symptom Attacks)

  • Menopausal symptoms

  • Male and Paternal Mental Health

  • Boarding School Experienced - Individuals who have difficult experiences from being sent to Boarding and Private Schools (which may be described as `Boarding School Syndrome`) or their loved ones who feel this is an issue which could be affecting them.

  • Care Experienced individuals

  • Relationships difficulties

  • Loss, change and grief

  • Parenting and Attachment issues

  • Obesity 

  • Groupwork

If you would like to enquire about my Counselling and CBT services please get in touch with me

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Dr Melanie Fennell a pioneering CBT Practitioner in the UK, believes that having low self-esteem (LSE) is the result of viewing and thinking negatively or critically of ourselves and putting an inaccurate low value on ourselves. 

By using Fennell`s CBT model for Low Self Esteem we can look at unhelpful ways of thinking and doing which we might have adapted to cope with negative self-beliefs e.g., I`m not good enough` to one which is more accurate and helpful.

Panic Attacks (and Limited Symptom attacks)

Panic is an anxiety disorder. Panic can be described as a discrete period of intense fear which seems to `come on` very quickly, almost `out of the blue`.

Symptoms can include `Rapid or pounding heartbeat`; `Feelings of unreality`; `Sweating`; `nausea’ and `Fear of losing control or going crazy`. There are 13 possible symptoms and to diagnose panic disorder there would need to be a feeling of a `sudden rush of panic` (which must peak within ten minutes) as well as at least 4 of these physical symptoms. ` Limited symptom attacks` describes situations where a sufferer experiences less than 4 of the 13 physical symptoms. They can be very unsettling despite having less symptoms.

CBT when used for Panic aims to reduce unhelpful cognitions and behaviours which when active cause the sufferer to misread situations as dangerous (which the body, mind and behaviour then react to) and eliminate avoidance. 

Social Anxiety 

Social Anxiety Disorder (SAD – also known as Social Phobia) causes fear and anxiety in social situations including eating in front of others; going to work; chatting at a party and public speaking. It can happen in some but not all social situations e.g., a sufferer may enjoy chatting at a party yet when they must talk in public this triggers performance related social anxiety. CBT is recommended for the treatment of SAD and there are lots of exercises we can use to help alleviate a lot of these symptoms.

“Worry never robs tomorrow of its sorrow, it only saps today of its joy.” - Leo Buscaglia

I suggest reading Gillian Butler's book 'Overcoming Social Anxiety'. 

Low Self Esteem 

Menopausal Symptoms and CBT

The menopause is a natural part of ageing that usually occurs between 45 and 55 years and refers to the process where a woman’s body adjusts to reducing oestrogen levels resulting in her body subsequently stopping the production of eggs. This can be a relatively trouble-free process for some while for others can be problematic.

Perimenopause is where women begin to experience menopausal symptoms as hormonal levels begin to fluctuate but are having periods. Periods change in regularity and level of flow. Perimenopause can last months though for some it can last years.

Menopause is when a woman has not had a period for 12 months, meaning that a woman can no longer get pregnant naturally as her body stops producing eggs.  On average symptoms can last four years however 1 in 10 women have symptoms for up to 12 years.

Early Menopause is when women begin the menopause before they are aged 45 which affects one in 100 women. Medical treatments Hysterectomy and Cancer treatment often cause this.

Research shows that CBT focussed mostly on the difficulties caused by these changes including `hot flushes` and `night sweats` helps women. Some may wonder how a physical or medical issue can be helped by using CBT. Treatment includes acknowledging the difficulties which are caused by changes in the `thermoregulatory system via the hypothalamus` (where the `thermo-neutral zone` is reduced causing extreme fluctuations in body temperature) by looking at how negative or unhelpful beliefs, predictions and behaviours can worsen symptoms.  

CBT in groups or 1:1 for Menopausal symptoms can include:

Relaxation and Paced breathing; Stress management and improving wellbeing; Setting individual goals (e.g., a change in behaviour like taking a daily walk); Stress, Lifestyle and problem solving; Managing hot flushes; Examining thoughts and beliefs and behavioural reactions; Applying relaxation and changes in thoughts, feelings and behaviour to deal with Hot Flushes and Night Sweats.

Boarding School Survivors or Syndrome 

Boarding School Syndrome is now being recognized as a specific psychological condition.

Psychoanalyst, Joy Schaverien first coined the term “Boarding School Syndrome” in 2011, after noticing common difficulties of former pupils among her patients which included problems with anger, depression, anxiety, a failure to sustain relationships, fear of abandonment and substance abuse. 

Nick Duffell, a psychotherapist and author of influential study, `The Making of Them` defines ex pupils as “boarding school survivors”. In his book `Trauma, Abandonment and Privilege: A guide to therapeutic work with boarding school survivors` he talks about the ways a child copes with being `sent away ‘. As an adult these ways of coping can include overworking and avoidance of intimacy. Nick describes the impact as `developmental trauma`.

In Britain, boarding education carries high social status, is considered a privilege, and is rife with parental expectation, which can make talking about the difficulties an individual has suffered as a result very difficult. It can be a taboo subject and sufferers can carry a lot of shame and guilt about having difficulties almost like they don`t have a right to complain or they have failed.

I have completed further training in this area which is not CBT based but can be effectively combined with what I have learned.

Relationship difficulties

Going through a separation, divorce, negotiating the modern world of dating, having a difficult time while in a relationship or entering a new relationship can all be really unsettling and challenging situations. These changes can often be scary and daunting but also exciting and positive. Relationship difficulties can make us feel insecure and change how we feel about ourselves and our identity. When relationships end, we can go through a lot of pain and this can bring up old painful feelings from the past.

Sometimes it can help just to see things from another perspective just to help work out the best way forward and using CBT can help.

“Growth is painful. Change is painful. But nothing is as painful as staying stuck somewhere you don't belong.”― Mandy Hale

Loss, change and grief

Often, we don`t acknowledge the impact of events in our lives. We may find it hard to speak about how we are affected by loss and grief when we lose someone significant for fear that we are a burden on others and `should be over it by now'. Sometimes it can be helpful to remember the person and acknowledge the void that has been left.

Losing a job or having a health issue which affects our usual abilities, or a friend all involves a degree of loss can affect us more than we think. 

Parenting issues

I have had extra training in issues around parenting which connects well with my CBT training. When children go through different stages of development like having `tantrums`; mood swings during adolescence etc this can trigger negative beliefs in parents.

 

People who don’t really know your child may give what I sometimes feel is unhelpful advice which can put unnecessary pressure on parents. When your child challenges you with their behaviour this can trigger unhelpful predictions for the future like `they`ll end up not being able to get a job`. Often parents worry that their child `will end up like me` and that this is bad or that how they feel mentally and emotionally will be passed on to their child.

 

In my experience there are no perfect parents only `good enough parents` and a parent who is worrying about these things is probably doing much better than what they think. Sometimes we can devalue the attachment or bond that exists between Parents (or Care Givers) with unhelpful comments like `they`re just attention seeking` and `you`re making a rod for your own back` which can cause Parents to question the way they parent. CBT can help look at this from a different perspective that is more helpful.

If you would like to talk about any of the services I offer, please get in touch below. 

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