What’s the fuss about ERP ?

Emma

ERP explained

ERP, (Exposure and Response Therapy) is an important part of any OCD treatment. It involves working with your therapist to ‘expose’ yourself to the thing you really don’t what to do (obsessional thought or belief about something ) and then NOT performing the behaviour (Complusion) you would normally do to bring a sense of relief/reduce distress.

Sadly, this relief is short-lived and the Compulsion negatively reinforces the behaviour (keeps it going).

For example, if I drive over a bump in the road and have a thought ‘What is I’ve run someone over ?’, that’s potentially upsetting. BUT, going back to check, googling local news for run over passers-by, and ruminating on my drive may reduce my distress this is a bear trap ! The OCD will always come up with the ‘What If…’ or provide a doubting thoughts to challenge your (shaky) certainty ! So, performing the compulsion whether a physical or mental ritual just keeps the whole thing going.

In therapy what I ask you to do (not straight away don’t worry !) is to gradually let go of these compulsions and slowly find out for yourself that nothing awful happens. This is also about helping you to change your relationship with the OCD thoughts and images that come in. Together, we work out (formulate) what the process is with your unique maintenance factors) and steadily reduce the compulsions with ERP.

Have any questions, why not get in touch ?!

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Top tips to build resilience during Covid-19

Emma

Covid-19 is here. Well, its all changed since I last blogged. I’m sending anyone reading this a virtual shake-hand or how about a hug eh ? I’ve been reading a lot of advice about looking after your anxieties and mental health in these uncertain times, and wanted to respond with a series of steps/ideas one post at a time with the intention of building resilience.

I also wanted to have time to reflect on what is working for me..rather than come out with try ‘XYZ’ just because I’ve read it somewhere !

CBT, Mental Health, Positive times, Uncategorized
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CBT in Strange Times

Emma

These are strange times. Anxiety is all about the unknown and the ‘what’ifs’, the things we can’t control. We feel under threat, in danger and our system is on high alert !

One of CBT’s skills I teach is thought challenging; looking at the thought in a more rational way and then reframing. Ok, what do we do when there is a potential risk to ourselves and others ?

I am reminded of the fabulous serenity prayer, always used in 12-step meetings, acknowledging what we can change, what we can’t and the wisdom to know the difference.

Some of this I can control, follow Government advice, wash hands, limit contact and the unknown is really the unknown and not in my gift or control. I could spend hours and days worrying, panic buying, getting stressed . But why? Can’t change it, only my reaction to what’s presented.

CBT, Mental Health, Positive Times, Uncategorized
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F1 Ad surprise !

Emma

At Last mental health advertisement in sport, namely Formula1 !

I love a bit of Grand Prix like many people, but not an avid fan. Although I may choose to catch-up on ‘Bake-off’ rather than join my boyfriend for 2 hours of speed, analysis and David Coulthard’s too snug trousers, F1 is fun, exciting and incredibly skilled.

So, I was pleasantly surprised and pleased to see one of the major insurers spending the big bucks during an ad break to encourage us, to talk and seek help if we’re struggling emotionally, with lots of shots of men. Given the unacceptable statistic that suicide is the biggest cause of death in UK men under 45, and approximenlty 75% of suicides are by men, a refreshing change from the usual macho ad nonsense.

Baby-steps on Big Tyres !

Mental Health, Uncategorized
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Limbic Emotion-Detecting Wearable

Emma

I’m not techy and if honest a bit weary of tech, and seem to have a special gift of breaking it ! So, I was understandably sceptical and also curious to be approached by Limbic to pilot their emotion-detection wearable device as a way to enhance CBT and the client/therapist experience. This is a world first and I think really exciting !

The client has a wearable device (linked with an app on their phone) which detects times of stress and change in mood and then prompts the client to log what happened, the intensity of the emotion (with emojis !) and CBT type questions to consider. This valuable information is fed into the client’s dashboard which I can see and use in session. This is an alternative to the client keeping thought records and perhaps easier to identify triggers, patterns and therefore targets for treatment.

Interesting times ahead, and looking forward to trying this as a therapist and from the clients experience.

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Mental Health Awareness Week

Emma

This week marks Mental Health Awareness week with a focus on Body Image. I’m sure there’s very few of us who haven’t struggled with this to a greater or lesser extent, myself included.

Having been a bit bigger than my peers in my 20s, without the pressure of social media I struggled to get fashionable clothes (most High St shops did the odd 14 if you were lucky !), and definitely felt my self-esteem was wrapped up in my body and how I perceived I looked to others.

Therefore, I really feel for young people today with images of ‘perfection’ just a click away, and for my age group now a new dialogue of ageing gracefully, au natural or trying to hang onto that youthful look.

My belief is while eating disorders, body dysmorphia are serious conditions, it all starts with acceptance of self, and liking ourselves. Images are enhanced and manipulated, and the idea of ‘perfection’ unrealistic. Our body may have curves and wobbly bits, and that critical voice may kick in when you look in the mirror, but that image does not define who YOU are.

CBT can help to challenge this negativity and enable you to be body positive ; Life’s too short.

CBT, Mental Health, Positive Times
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Feeling CALM with the Connor Brothers.

Emma

Last Thursday I was thrilled to attend a dinner at The Artists Residence London, in aid of CALM (Campaign against living Miserably) a leading movement against male suicide. The Connor Brothers, http://www.theconnorbrothers.com, are fictional twins, but in real life great friends who produce fabulous pulp fiction images with words that resonate at several levels. Mental health issues are something they are passionate about and it was great to meet them and Ben at CALM to learn more about this important issue. The food was pretty fab too.

Tell Me Beautiful Untrue Things
An example of The Connor Brothers work who hosted a dinner with CALM at The Artists Residence London.

It is my experience that men tend to be more reluctant than many women to get help and therapy. Sadly that culture about ‘man up’ ‘stiff upper lip’ carries on, and I was shocked to learn that suicide is the single biggest killer for men under 45. I appreciate all clients find it difficult to ask for help and make that first contact with a therapist, GP or mental health services, but if you are struggling whatever your gender it’s ok to say ‘help’, and let that lip wobble.

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‘Pure’ is pure Joy!

Emma

Once in a while a ground-breaking TV programme comes along about mental health. ‘Pure O’ as its sometimes called, part of the Obsessive Compulsive Disorder (OCD) family on Channel 4 is just brilliant. Pure O is categorised by unwanted intrusive thoughts which are distressing. Their content can vary from blasphemous, highly sexual or murderous, and abusive.

The thoughts are frequent and upsetting. The person fears that if they disclosure the content of the thoughts, they risk rejection of friends and family and partners. So, you can see why people who have this form of OCD are reluctant to seek help.

This brilliant comedy drama played by Charly Clive follows Marnie a 22 year old woman who moves from her rural Scottish town to London to find out what is wrong with her and discover herself. She has frequent sexual thoughts and images relating to men, women, and family members often triggered by those around her.

OCD drama on Channel 4-Marnie (Charley Clive) and friends in 'Pure'
Marnie (Charley Clive) and friends in ‘Pure’

Sadly, some tabloid journalism have labelled this as ‘soft porn’, but what it does is explicitly show the kind of distressing thoughts and images many people are trying to live with.

We ALL have unwanted thoughts just pop in our mind and images, sometimes triggered by a reference to that even/person/thing but these don’t upset us. For the person with ‘Pure O’ thoughts are highly upsetting and secretive due to the highly personal nature, which leads to avoidance of those situations. For example , if you have thoughts about harming your child in some way, the tendency can be to ruminate on ‘what does this say about me, ‘it must mean that I really want to hurt my child’ and then you start to avoid contact with them and take especial precautions whilst being understandably very distressed and anxious.

The irony is, that the content of the thoughts are often the opposite of what we would want in real life. Thoughts are just thoughts, not actions; subconscious desires a sign of us being bad/evil/a paedophile. Marnie (I’m only a few episodes in) having tried to have sex with a woman and then joined a sex addicts group has realised she has ‘Pure O’ and is now seeking therapy.

CBT is effective at helping the person to manage their symptoms and medication can help in addition. So do check out this ground-breaking drama, which doesn’t take itself seriously and doesn’t sugar coat the experience. If this sounds familiar and you want someone to talk to about your unwanted intrusive thoughts do get in touch, help is out there.

OCDaction and OCDUK are great websites for further information.


CBT, Mental Health, Uncategorized
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CBT and the Menopause; Hopeful of Hove !

Emma

Hot flushed of Hove

  BBC The Truth about Menopause   Wasn’t this a fabulous programme ?! Sadly I find myself in the ‘woman of a certain age’ bracket (surely too young) to be experiencing peri-menopausal symptoms. Despite my therapy brain trying to rationalise and calm, it’s amazing how a drop in Oestrogen can bring out the irrational and emotional self . Thank goodness for programmes like this, and a good GP to chew over the choices.

However, Mariella Frostrup has helped to get us talking about the menopause in all its forms, dispel some myths, look at facts and suggest treatments that work. I was pleased to learn that CBT has been trialled at Kings College London and shown to reduce some of the symptoms by changing perceptions such as anxious responses when the flush wave strikes. Physician heal thyself !

CBT, Mental Health, Positive times
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Hove seafront don’t miss it!

Emma
Photo of Hove seafront October morning 2018
Colourful beach huts on Hove seafront

I try to be mindful, and try, and try ! Walking along Hove seafront most mornings I’m struck by how many people are either looking at their phone or plugged into their music or having a conversation.


I don’t know about you but I’m really bad as multi-tasking. My intention when I might make a call, look at my phone is a way of saving time. However, the truth is I lose valuable time, by missing out on my daily walk, and that space before work with myself and my thoughts.

Its only by giving ourselves these spaces, we can tune in and observe, “How do I feel”, “What’s going through my mind” and be present to whatever is going on for us. Sometimes the most difficult thing is to ‘feel the feelings’ and experience the discomfort .

Psychologically we get into trouble when we repress, ignore our emotions by distraction, avoidance or using substances, tempting though that is. Being digitally connected is a socially acceptable way of doing this, but we rob ourselves of the here and now, of being present.

So, here’s my challenge; make your journey to work, to school, to college gadget free tomorrow, experience the life around you, observe the people , surroundings and your internal world. Notice what happens and accept it.
Want to know more about being mindful ? Check out the Headspace website,

CBT, Mental Health, Mindfulness
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