Sian Jones Cognitive Behavioural Therapy

25/04/2022

05/05/2021

What is Health Anxiety?

Health anxiety is an irrational worry about having an illness or disease. Those affected by health anxiety have an obsessional preoccupation with the idea that they are currently (or will be) experiencing an illness/disease.

They might spend hours on the Internet researching health information. When they get a sore throat, they automatically think it could be something serious, such as throat cancer and dismiss the fact that it is probably just the start of a cold. Even when GP tests come back negative, it only gives temporary relief before the anxiety about another symptom starts again.

Although some people refuse to be examined by their doctors, through of fear of discovering the worst. Others constantly seek reassurance from their GP, insisting on repeated medical tests.

Visits to the A&E are also common in health anxiety. However, once seen by a doctor, the vicious cycle quickly resumes as new thoughts and physical sensations surface. Followed by more interpretations and more visits to doctors, in the search for certainty that there is nothing wrong with them. Read more http://bit.ly/HealthAnxietyCBT

25/01/2021

Cognitive Behavioural Therapy - Skills to Beat Anxiety

The problem of uncertainty

Numerous studies have shown that an intolerance of uncertainty is a key factor in evoking anxiety. People who believe they cannot tolerate uncertainty often procrastinate, avoid situations, seek constant reassurance and/or carry out excessive checking.

Ref - Carleton et al “Certain About Uncertainty” https://pubmed.ncbi.nlm.nih.gov/22366534/ 2012 (accessed 22 January 2021)

Because uncertainty is distressing for some of us, many people try to control or eliminate it altogether. For instance, when a person with OCD washes their hands compulsively, they’re really trying to control the uncertainty of getting contaminated.

Or, when a person with health anxiety believes there is something wrong, they try to control their discomfort by ‘Googling’ their symptoms or making an appointment with their GP to gain certainty they are not ill.

In reality, these compulsive behaviours only provide a temporary relief from distress and instead. only intensify the obsession. Avoidance also feeds the original fear and it keeps growing and growing.

Learn to recognise rumination.

Rumination is the process of continuously worrying about the same thoughts. Thoughts that tend to be negative or dark. The habit of rumination impacts mental health because it can prolong or intensify anxiety - as well as impairing your ability to think and process emotions rationally.

The best thing to do when you're ruminating is to accept the thoughts as ‘just thoughts’ We cannot control our thoughts and neither do they do us any harm. The only control we have over our thoughts is how we respond to them.

Therefore, by allowing them to pass in their own time rather than trying to block them out lessens the impact on our emotions. It is also helpful to recognise that your thoughts might not be accurate/factual so and by trying to avoid distressing thoughts just increases the intensity and intrusion of the thoughts you're trying not to have.

Recognising unhelpful thought distortions.

Cognitive distortions, also known as thought distortions are habitual, irrational ways of thinking, that are usually inaccurate and negatively biased. They are irrational because they are rarely fact based and tend to be based on something that hasn’t happened the ‘what if’s’

Cognitive distortions tend to develop over time, in response to adverse events. They are often reinforced through our thoughts and what we tell ourselves.

“I have got a pain in my chest, I must have cancer”

“My husband is late home. It’s raining, his car must be upside down in a ditch“

These are all classic examples of cognitive distortions: thought patterns that cause people to view reality in inaccurate — usually negative — ways. In short, they’re habitual errors in thinking. When you experience cognitive distortions, your interpretation of events are usually negatively biased.

Most people experience cognitive distortions from time to time. But the continual reinforcement can increase anxiety, lead to depression and cause relationship difficulties.

Different types of thought distortions

Polarised thinking

Sometimes called black or white or all or nothing thinking. This distortion occurs when people get into the habit of thinking in extremes.

When you’re convinced that you’re either destined for success or doomed to failure, that the people in your life are either angelic or evil, you are probably engaging in polarised thinking.

This kind of distortion is both unrealistic and unhelpful because most of the time reality exists somewhere between the two extremes.

Catastrophising

Catastrophising is another form of distorted thinking. This is when someone assumes that the worst will happen (even though they are often not sure what the worst really is) It involves believing that you are in a worse situation than you really are - or exaggerating the difficulties you face.

When people catastrophise, when faced with the unknown or an uncertain situation, ordinary concerns can quickly escalate.

For example, if a self-employed person has no work for a period of time, they may catastrophise that, as a consequence, that they may not be able to pay rent/mortgage and the whole family will be homeless.

Alternatively, for people who experience health anxiety - a chest pain can quickly escalate to them believing they having a heart attack and will ultimately die.

Demands

Demands are when people find themselves thinking in terms of what they “should” or “shouldn’t “do or what they “want or “don’t want” Demands don’t change anything – they only increase anxiety.

When we start accepting our thoughts instead of demanding we don’t have them - they tend to go away. This means, changing our internal language from a demand such as “I don’t want to keep worrying, I can’t bear it” to a preference, such as “It would be nice if I worried less- but worries won’t hurt me. I may not like it, but I know I can tolerate it”

Emotional reasoning

Emotional reasoning is the false belief that your emotions are the truth and the way you feel about a situation means it is fact.

There is a very true saying “just because I feel bad doesn’t mean it is bad”

Emotional reasoning is a common cognitive distortion. It’s a pattern of thinking that’s used by people with and without anxiety or depression.

The key is recognising thought distortions is to ask yourself is it I am exactly thinking you are when you feel distressed. What exactly are you worried about. It is important to be clear on this because some thoughts are likely to be cognitive distortion.

How to help yourself

Work through anxious thoughts

Cognitive restructuring is a powerful way to get more comfortable with uncertainty. The basic idea is to no longer ‘blindly’ accept the automatic negative thoughts and instead develop the skill of challenging them.

For example, if the thought is “I can’t bear not knowing about….” Replace it with this more realistic/rational thought: “I would prefer it if I could be certain about…. I don’t like it but I can deal with it.”

The use of mindfulness techniques.

Mindfulness is a type of meditation in which you focus on being intensely aware of what you're sensing and feeling in the moment, without interpretation or judgment. Practicing mindfulness involves breathing methods and other practices to relax the body and mind and help reduce stress.

Be kind to yourself

Criticising or getting frustrated with yourself when you make a mistake or are unhappy with the with how you behaved is likely to lead to rumination and avoidance.

Research has shown that by accepting and talking kindly to yourself, not only helps you feel better, it also increases the motivation for self-improvement.

Seek professional CBT help

CBT can help by bringing awareness to the thoughts which lead to distorted thinking patterns about yourself and your situation.

CBT is about taking ‘emotional responsibility’ for your feelings. That doesn’t mean you are to ‘blame’ but it does mean you (as we all are) responsible for how you respond to things.

CBT is not about making you ‘happy’ when negative situations arise or people behave in a way that you don’t happen to like. CBT is about enabling you to be rational in such an event by dealing in fact and evidence as opposed to your interpretation or beliefs.

If you would like to make an appointment for some professional help contact https://www.sianjonescbt.co.uk/book-now/

11/07/2020

Our experienced therapists are offering both Zoom and Skype Counselling at a time that suits you. Click here to request an appointment. https://www.cbtandcounsellingkent.co.uk/request-an-appointment/

11/05/2020

The Fear of Uncertainty

Lynn Garbutt offers CBT therapy at Sian Jones CBT in both Ashford and Egerton practice. Lynn provides some guidance below on how to manage anxiety during uncertain times.

What is behind fear?

It is common to feel uncomfortable when there is uncertainty about the future. Or, if we don’t feel in control of things happening in our life. It goes without saying, that we would all like to know that our job and income are fully secure, so we are able to pay our mortgage/rent and bills.

We would also like to be certain that the dream holiday we have booked will turn out as we imagined, and we have a safe, trouble free flight. Invitations to parties, which are supposed to fun, can also fill us with uncertainty. Questions can run through our mind, such as ‘who will be there?’ or ‘what if nobody talks to me’ or ‘I won’t know what to say?’

Although these are quite natural, human concerns, it is when concern turns to anxiety, that it can leave us feeling out of control or debilitated.

Where does fear begin?

We tend to experience fear when we cannot predict a definitive outcome in a given situation. And we are all different in how much uncertainty we are prepared to accept. Some people enjoy taking risks, while others prefer to have a more certain handle on the future. Although all of us have a limit, if you feel overwhelmed by uncertainty and it causes anxiety, it is important to recognise that you are not alone.

It is also important to understand, that no matter how anxious you feel, there are steps you can take to deal with situations that are uncontrollable, alleviate your anxiety, and face the unknown with more confidence. When people fear uncertainty or losing control, they often find ways to lessen that uncertainty and gain some control in other areas of their lives.

This can sometimes lead to obsessive compulsive behaviour (OCD) in a desperate search to feel in control over and manage other situations. It can often be in a form of superstition. For example, ‘if I perform this ritual then everything will be ok’.

People who fear uncertainty, tend to believe that they MUST control and know the outcome of future events. They also believe that they just CANNOT cope without that knowledge! This is known as ‘catastrophising’ - believing something a might awful will happen (even though they rarely think through what that terrible thing might be). Chronic sufferers are often continuously in a heightened state of anxiety, with only brief periods of relief.

Preferences vs demands

The root of this problem often stems from ‘demands’ (the shoulds’, musts and needs) for certainty - in a world that is full of uncertainty. For example, “I MUST know that everything is going to be OK” which is the unhelpful belief that we NEED to know the outcome of all future events, in order to be able to tolerate it.
This uncertainty leads to uncomfortable feelings of worry and anxiety. This conflict between the ‘demand’ for certainty and the reality that we cannot be certain about everything that will keep the anxiety cogs continually going around.

It goes without saying; we would all like to know for definite that our loved ones are safe, and our jobs are secure. However, demanding that we have certainty about it, does nothing to guarantee the outcome. The only thing it does is lead to us to feeling worried, unsure and anxious.

By recognising what is in your control and what is not - and start facing the unavoidable doubt about what could happen in the future can indeed seem formidable. But it is the first step in letting go of the fear. Not having certainty, it can indeed feel uncomfortable, however, when you recognise that is ALL it is ‘uncomfortable’ you stop fighting the feeling and it becomes so much easier to bear.

How to manage anxiety

It is important to understand the difference between a ‘demand’ and a ‘preference’. Demands are inflexible, unaccepting ways of thinking. That's because we only want, or do not want, one particular outcome.

‘Preferences’ on the other hand are much more flexible and much more accepting of ourselves, situations and other people.

Here is an example - When we go on holiday, we all like to arrive on time and safely as planned. There are some elements of the holiday within our control – like packing our favourite clothes. However, if the plane is delayed by 3 hours this is completely out of our control.

We have no control over what we think or how we feel about the delay, but we do have control over how RESPOND to it. For example, we could go to customer services and demand that the plane arrives on time. We could argue and tell everybody how unfair it is that our holiday is off to a bad start and feel thoroughly miserable. Or alternatively, we could acknowledge that we would ‘prefer’ things to be different but accept the situation for what it is. This does not mean we necessarily like it however, but we are at least rational about it.

A preferential response in this situation might be along the lines of - “well I would have preferred it if we had left on time, but it’s out my control. Therefore, I may as well sit down have a coffee and read my book” In both cases the plane is still delayed, but your view on the delay is different and by holding that preference you are less troubled and anxious.

Stoic thinker Epictetus suggested that ‘People are disturbed not by things but by the views they take of them” He claimed that mental attitudes such as desires, hopes, wishes (preferences) are generally in your control. Whilst external events - including whether you know the outcome of future events - are not.

We can of course, take reasonable precautions to keep us safe from harm and put things in place to try and ensure things go to plan. However, it is important to accept, there are some things we have no control over, but we can enjoy our lives anyway. When we learn to accept and turn our ‘demands’ into ‘preferences’ we are taking the first step into overcoming the fear of losing control and uncertainty.

A last point to think about. Imagine you are trying to cross a road to get to a beautiful beach on the other side. It would of course be foolish to cross if a car was coming. But it would be even more foolish and self-defeating to not cross that road at all, if there was no car in site - just in case a car came along! Do not let fear stop you from crossing your road!

How CBT therapy can help

Cognitive behavioural therapy is not about encouraging you to ‘enjoy’ situations that you don’t happen to like. It’s about helping you understand the importance of being logical and rational in your response.

Additionally, it’s about learning to understand – even when we don’t necessarily ‘like’ a situation we are still able to tolerate it. CBT is also about helping you become more accepting of yourself, other people and situations.

If you would like some professional help on how to manage anxiety. Please contact us at Sian Jones CBT today.https://www.sianjonescbt.co.uk/contact-us/

09/01/2020

The Difference Between Anxiety and Depression

If you were to ask someone to name two common mental health problems, chances are they will say anxiety and depression. Even though they are commonly referenced in conversation, people still struggle sometimes to determine the difference between these two conditions. This is because many people with anxiety also develop depression and vice versa

What is depresssion?

Depression is more than simply feeling unhappy or fed up for a few days, we all go through spells of feeling down. When you are depressed you feel persistently sad for weeks or months. If left untreated, it can go on for years.

Some people still think that depression is trivial and not a genuine health condition. They’re wrong. Depression is a real illness with real symptoms, and it’s not a sign of weakness or something you can “snap out of” by “pulling yourself together”.

Depression is a mood disorder with a wide range of other possible symptoms, which will vary from person to person. It can develop quickly or gradually and be brought on by life events and/or changes in body chemistry. It can strike anyon, but is curable in vast amount many cases.

Depression is one of the leading causes of disability worldwide and a major contributor to su***de and coronary heart disease

24% of women and 13% of men in England are diagnosed with depression in their lifetime

Depression often co-occurs with other mental health issues.

Depression occurs in 2.1% of young people aged 5-19.

Major depression is more common in females than in males.
Although, in 2018, males continue to account for three-quarters of su***de deaths in the UK (4,903 male deaths compared with 1,604 female deaths. Source - http://bit.ly/OfficeNS

Resource - http://bit.ly/mhfaengland

Although anxiety and depression and are two different mental health problems conditions, their symptoms and treatment can often overlap.

Symptoms of depression

- lacking energy or feeling tired
- feeling exhausted all the time
- experiencing 'brain fog', find it hard to think clearly
- finding it hard to concentrate
- feeling restless and agitated
- feeling tearful, wanting to cry all the time
- not wanting to talk to or be with people
- not wanting to do things you usually enjoy
- using alcohol or drugs to cope with feelings
- finding it hard to cope with everyday things and tasks

Depression can often come on gradually, so it can be difficult to notice something is wrong. Many people try to cope with their symptoms without realising they're unwell. It can sometimes take a friend or family member to suggest something is wrong.

What is anxiety?

Anxiety is what we feel when we are worried, tense or afraid. Particularly about things we think could happen in the future. The “what if’s” in life. Anxiety is a natural human response when we perceive that we are under threat, experienced through our thoughts, feelings and physical sensations.

Anxiety is all about threat and danger (either real or imagined). The fear you experience becomes irrational and out of proportion to the actual threat itself.

Many people with depression may experience anxiety in addition to their low mood. People who feel anxious often feel tense, restless, and have trouble concentrating because they worry so much. Often, they are deeply afraid that something bad is going to happen or that they might lose control of themselves.

Symptoms of Generalised Anxiety Disorder (GAD)

GAD can cause a change in your behaviour and the way you think and feel about things, resulting in symptoms such as:

restlessness
a sense of dread
feeling constantly "on edge"
difficulty concentrating
irritability
withdrawal from social contact (seeing your family and friends) to avoid feelings of worry and dread.
you may also find going to work difficult and stressful and may take time off sick. These actions can make you worry even more about yourself and increase your lack of self-esteem.

Physical Symptoms of GAD

GAD can also have several physical symptoms, including:

ttiredness
dizziness
a noticeably strong, fast or irregular heartbeat (palpitations)
muscle aches and tension
trembling or shaking
a dry mouth
excessive sweating
shortness of breath
stomach ache
feeling sick
headache
pins and needles
difficulty falling or staying asleep

If you’ve experienced these symptoms most days for more than six months and they cause distress in your daily life, then you may receive a diagnosis of generalised anxiety disorder. Other types of anxiety disorders include separation anxiety, panic disorder, or phobias, among others.

The difference between anxiety and depression

if you compare the two lists of symptoms, you can see that some overlap. Sleep problems, trouble concentrating, and fatigue are all symptoms of both anxiety and depression. Irritability may also manifest in forms of anxiety or depression (in place of low mood).

However there are distinguishing features -

People with depression tend to move slowly and their reactions can seem flattened or dulled. People with anxiety tend to be more 'keyed up' as they struggle to manage their racing thoughts.

Seeking Help

GP Diagnosis

If you have anxiety, depression, or both, chances are that your GP will recommend medication, therapy or a combination of the two.

Selective serotonin reuptake inhibitors (SSRIs) are a widely used type of anti-depressant They're mainly prescribed to treat depression, particularly persistent or severe cases and are often used in combination with a talking therapy such as cognitive behavioural therapy (CBT). Source http://bit.ly/NHSUK

SSRIs are usually the first choice medication for depression because they generally have fewer side effects than most other types of antidepressant. As well as depression, SSRIs can be used to treat a number of other mental health conditions, including generalised anxiety disorder.

Professional talking therapy

Counselling or Cognitive Behavioural Therapy (CBT) for depression can help you understand your own expectations which might be unrealistic or difficult to maintain. It can also provide you with strategies to help both alleviate and prevent depressive symptoms from recurring in future. Furthermore it can show you steps to help find alternative ways of dealing with life’s challenges.

Cognitive behavioral therapy (CBT) is also the most widely-used therapy for anxiety disorders. Research has shown it to be effective in the treatment of panic disorder, phobias, social anxiety disorder, and generalised anxiety disorder, among many other conditions.

CBT addresses negative patterns and distortions in the way we look at the world and ourselves. As the name suggests, this involves two main components:

Cognitive therapy examines how negative thoughts contribute to anxiety.

Behaviour therapy examines how you behave or respond to situations that trigger anxiety.

The basic premise of CBT is that our thoughts—not external events—affect the way we feel. In other words, it’s not the situation you’re in that determines how you feel, but your perception of the situation.

The most important quality that anxiety and depression share is that they are both very treatable. Don't hesitate to be informed and find the right help, so you are on the right track towards a healthier mind and body.

To find our more or book an appointment visit us at https://www.cbtandcounsellingkent.co.uk/ or e-mail sian@CBT andcounsellingkent.co.uk

For more urgent help there are a number of free helplines below:

The Samaritans http://bit.ly/TheSamaritans offer a 24-hours a day, 7 days a week support service. Call them FREE on 116 123. You can also email jo@samaritans.org

CALM (Campaign Against Living Miserably) https://www.thecalmzone.net/ have a helpline (5pm – midnight) and webchat to support men

Papyrus - https://papyrus-uk.org/ is a dedicated service for young people up to the age of 35 or if you are concerned about a young person.

You can call the HOPElineUK number on 0800 068 4141 or you can text 07786 209697

30/09/2019

Getting Over A Relationship Break Up

People often contact us following a relationship break up. That’s because a romantic break up can be one of the most traumatic experiences a person can go through. With the feelings often described as, or likened to, as the stages of grief. It’s astonishing to think that nearly every one of us will experience a break up at some point during our lives.

The word ‘breakup’ tends to trigger depressing images in our minds. Such as crying into a beer or eating pots of ice cream with friends telling us ‘you will get over it’ and ‘there are plenty more fish in the sea’.

Relationship Counselling Kent (part of Sian Jones CBT) offers some tips on how to truly get over it. Read more....https://www.relationshipcounsellingkent.co.uk/relationship-break-up-relationship-counselling-kent/

02/12/2018

How To Deal With Anxiety.

https://www.sianjonescbt.co.uk/

12/01/2018

New Year New You - Time For Change!

28/09/2017

How Emotionally Intelligent People Express Anger/Frustration

Most of us don’t like confrontation and will avoid it where possible. However, it’s a fact of life that we can’t run away from it forever. There are times we have to assert ourselves, our boundaries and our needs and others will want to do the same with us.

There are a vast number of unpleasant ways in which we can express anger and frustration, but it’s guaranteed that they will almost, always be unproductive and ineffective. The unhealthy negative emotion of anger is also exhausting. We might think we feel good during a 60 second rant at another person, but one things for sure, once we have calmed down, we always end up feeling bad about ourselves.

Greater Emotional Intelligence Gets You The Results You Actually Want.....

Anger - both direct or passive- is meant to communicate something we deem important. However, it tends to have the opposite effect by driving people away. So when what you really want is to connect and be heard, the end result is often the opposite and you can end up destroying your relationships. Any form of aggression is the biggest obstacle to emotionally intelligent communication.

People often think passive-aggressive communication is somehow better or “nicer” - it’s not. In fact, it might actually be worse. The French have an expression for passive aggression: sous-entendu - which means “what is understood underneath.” In other words, you’re saying one thing (that on the surface sounds quite innocent) but you actually mean something quite different (which can be quite vicious). Unfortunately, passive aggression is what many people resort to.

Research shows that a hostile communication style will drive people away: whether you’re aggressive or passive aggressive, people will react negatively to you. They will feel uncomfortable, they won’t understand what is going on and they’ll want to get away from you.

Here’s what to do instead...

Take responsibility for how you respond to situations and any feelings they make evoke in you. When we feel angry, it’s all we can think about. If you are feeling angry, take a breath and think things through. Although you might feel desperate to deliver the reasons behind your frustration, your message will not be delivered effectively. When another person is on the receiving end of an angry outburst, all they hear is anger, not what that person is actually saying.

Understand your negative emotions. Are you really angry? Or are you perhaps hurt or jealous instead and lashing out? Sometimes, we think we’re frustrated with a person or a situation, but the truth is, we’re actually feeling pain or the threat of rejection. It takes courage and honesty to take responsibility for the real reasons behind your negative frustrations.
Are you basing your anger on fact or interpretation? It’s easy to jump to conclusions based on feeling surrounding what we believe something to be rather than what is actually is. There’s a useful saying ‘just because we feel bad doesn’t necessarily mean it is bad’. Take the time to find out if your interpretation of a situation that frustrates you is factually true. Or has someone unwittingly fallen short of your expectations/moral code and you're misplacing blame? Remember, they are your expectations only and it’s too easy to blame somebody else for how we feel.

Put yourself in someone else’s shoes. Focusing on why you’re angry or frustrated keeps you focused on yourself. Research shows that negative emotions make us self-centred, which means there is no room for another person’s perspective, because you’re so locked in your own view of things. Putting yourself in somebody else’s shoes enables you to think through why the other person might be saying a certain thing or acting a certain way. Instead instantly confronting them, just ask them with why they said what they said or did what they did, so you know their exact intentions. The vast majority of people don’t go out of their way to purposefully anger or hurt someone. Sometimes it happens accidentally, but more often than not, the reasons behind someone else’s actions, are about them only, and not about anyone else. By taking the time to understand, without immediately attributing blame, goes a long way in easing any negative emotions you might be experiencing.

Demonstrate compassion. When you take the time to understand another person’s point of view instead of immediately assuming the worst, you are actually inviting effective communication. You are showing respect and consideration for another person’s right to think, feel and act in a certain way. This is important in any communication with other people, but it is especially important in our romantic relationships, because it will develop a deeper relationship based on understanding, respect, compassion and empathy. If you approach someone with aggression; they will feel defensive and angry in return. On the other hand, if you approach the other person with respect and are prepared to listen to their perspective, then they will be more prepared to hear yours in return.

Communicate Skilfully. Share your perspective by using the word "I" and talking about how you feel. Try never to start a conversation with ‘you make me feel’ because in general that come across as a criticism of the other person. However, don’t just talk about your perspective, ask the other person to share their perspective and engage with it sincerely. Show interest in their view and where there are difference and explore together how you can come to a compromise going forward.