Counselling & Psychotherapy for Anxiety

In: Anxiety, Featured Home, Individual psychotherapy

Anxiety is one way to respond to an external event that we see as a threat. In a state of anxiety, some of our physical and mental functions are heightened so that we are able effectively to confront what is threatening us, or to escape it. This is referred to as the “fight-or-flight response”. As such, it has been essential to our survival as a species, and continues to serve us in situations of severe danger.

However we find that we often experience it in situations that don’t really call for it.

What is anxiety for?

In itself, anxiety does not teach us anything about its causes. It does not tell us anything about the best way to resolve a problem. It does not tell us how to be less anxious. It just prepares us for a very simple response – fight or flight. We may even find that, in a state of anxiety, we are less able to act, as a situation really requires – in these cases, anxiety clearly “gets in the way”!

So, paradoxically, anxiety can end up decreasing our quality of life, sometimes to the extent that it becomes intolerable. It is estimated that about one in six adults experience levels of anxiety that they feel are excessive and debilitating, with 1.5 to 3.6% of these being diagnosed with General Anxiety Disorder (Carter RM, Wittchen HU, Pfister H, et al, 2001).

How does counselling and therapy for anxiety help?

People who have come to see me for psychotherapy and counselling at my London practices have wanted help with finding out why they were excessively anxious, and what they could do to change this. It is therefore my aim to help my clients:

  • better contain and express their anxiety
  • understand the cause(s) of their anxiety
  • develop ways of responding more appropriately to their environment
  • make decisions concerning the causes of their anxiety

It is through our understanding of the root causes of our anxiety that we can see clearly how we could change certain aspects of our lives. It is my aim to support my clients in developing this clarity and making essential life changes.

By: Cedric Tags: ,

Addressing social anxiety through psychotherapy

In: Anxiety, Featured Home, Individual psychotherapy

What is social anxiety?

Most online and offline publications will define social anxiety as the excessive fear of social situations. People who have come to see me for help with this problem have also often described that they may feel discomfort in any social interaction, even if this is with “just the one person”. Because of this, I prefer to define social anxiety as the discomfort that relates to the experience of any relationship.

«In every contact, we communicate a bit of ourselves to the other, and the other is there to receive it, for better or for worse. In that respect, every social situation is significant, because it says something about us.»

Why does it happen?

We form our person and our character in the context relationships – to the family we were born in, to the community around us, to school, to our chosen communities of friends, spouses and children, to our communities at work. These relationships are not just a backdrop to our lives: by interacting within them, we evolve through them, and them through us.

It is perfectly healthy to feel a measure of trepidation in all forms of contact with other people, whether it is a brief exchange with a waiter, a discussion with a headmaster, or a presentation in front of the board of a company. After all, every personal contact, no matter how brief or apparently shallow, is an  experience that engages our person, consciously and unconsciously. In every contact, we communicate a bit of ourselves to the other, and the other is there to receive our communication, for better or for worse. In that regard, every social situation is significant because it says something about us.

«Psychotherapy, to be effective, must include two aspects at least: reflection on oneself and action on one’s environment.»

When does it become a problem?

However, for many, this creates a level of discomfort that can feel difficult to bear, which may lead some to assuming that all social contact will be painful, and therefore to avoiding certain social situations, and sometimes, most, if not all, social situations. This can be extremely distressing and debilitating.

Addressing the issue

It is my experience that psychotherapy, to be effective, must include two aspects at least: reflection on oneself and action on one’s environment. This is especially true when the concern that needs addressing is social anxiety. Action alone, which can be, for example, challenging one’s assumptions about other people’s thoughts about us and changing the way we interact with them, is not enough to create a deep-seated sense of safety in a social setting. Similarly, reflection alone will not help the person to “land” the insights acquired and create new and more helpful behaviours.

Therefore, I encourage my patients to:

  • take a historical perspective on their experience of social interactions
  • examine the feelings, thoughts and sensations that they associate with them
  • get a deeper sense of who they are as a person, and what sort of social existence they are really meant to live
  • observe in detail what they go through as they apply their insights and progressively approach life with others in different ways

The quote by St Francis of Assisi sums quite well my approach to helping people address their social anxiety, as it reflects its progressive nature and the surprises that can arise out of the process:

«Start by doing what’s necessary. Then do what’s possible; and suddenly you are doing the impossible»

By: Cedric Tags: ,
Depression can indeed feel like a bottomless pit

In a few words: depression combined with anxiety

In: Anxiety, Depression, Individual psychotherapy, Short articles (<500 words)

Depression with Anxiety: a common problem

Very often, psychotherapists in London and elsewhere will mention under the same breath that they help people with “anxiety and depression”, almost as if it were one and the same thing. This is probably because, according to the ONS, there are almost three times more people who suffer from both depression and anxiety that people who suffer from depression alone. Indeed, depression with anxiety is experienced by 9.2% of people in Britain, while depression without anxiety by 2.8%.

What is the relationship between anxiety and depression?

It is hard to say if unmanageable anxiety triggers depression, or if a state of depression generates anxiety. It depends highly on individual cases and even then It often feels like a circular situation and in my experience it is not helpful to try and find out what came first. The essential is to help the client address these feelings as a whole in their therapy, and to consider anxiety and depression as intricately linked as opposed to separate phenomena requiring different approaches.

An apparent paradox

It sometimes seems paradoxical that depression, whose symptoms are said to be mostly negative (i.e., describing the absence of something), can co-exist with anxiety, whose symptoms are mostly positive (i.e., describing the presence of something). For example, in depression, sufferers experience lowered mood, loss of motivation, loss of meaning and loss of concentration, while in anxiety it is the positive symptoms that seem to prevail, for example, increased heart rate, presence of recurrent unpleasant thoughts and restlessness.

How to approach individual treatment of mixed anxiety and depression

As an experienced counsellor having helped many people deal with issues of mixed anxiety and depression in London, I have noticed that people suffering from this problem fall in three very broad categories:

  • those who feel that they will benefit more from guidance and education, and expect from the therapist clear instructions and coping strategies,
  • those who prefer a non-directive approach and want to explore their experience in an open, unstructured manner,
  • and those who feel that it is most helpful for them to experience both in their therapy.

As an integrative psychotherapist, I believe that it is best to offer my clients what is going to be helpful to them and not just what a specific approach says I should do. This is why I mostly offer my clients a space to be with themselves and also a forum where they can clarify, understand and plan concrete life changes.

By: Cedric Tags: , , ,