Psychological therapy
Therapy is a space to work on how you are feeling, with someone whose job is to take it seriously and help you make sense of it. I work with adults experiencing difficulties such as anxiety, low mood, stress, grief, sleep difficulties, and adjustment to change.
You do not need a diagnosis, a referral, or a particular reason to come. Some people arrive with something specific they want to shift. Others arrive knowing only that things have felt harder than they should for a while. Both are a reasonable place to start.
What I can help with
Anxiety and worry - Both physical anxiety, meaning body sensations such as a racing heart, tight chest, restlessness, nausea, muscle tension and disturbed sleep, and mental anxiety, meaning racing or looping thoughts, anticipating the worst, and difficulty switching off. Often in the form of generalised anxiety disorder (GAD), social anxiety disorder, panic disorder, obsessive-compulsive disorder (OCD), specific phobias, and health anxiety.
Stress and burnout - The effects of sustained pressure at work or at home, including exhaustion that sleep does not fix, irritability, difficulty concentrating, physical tension, and a growing detachment from work you used to care about. Burnout is not a diagnosis in its own right, and it commonly sits alongside anxiety, depression and adjustment difficulties.
Adjustment to change - Difficulty coping in the months after a significant change, such as a new diagnosis, a change in health or cognition, an injury, retirement, redundancy, a relationship ending, or a move. Low mood, worry, difficulty functioning at work or at home, and a sense of not having landed yet. Where the reaction is out of proportion to the change, or is getting in the way of daily life, this may be diagnosed as adjustment disorder.
Low mood and depression - Persistent flatness or sadness, loss of interest and enjoyment, low energy and motivation, changes to sleep and appetite, difficulty concentrating, withdrawal from people, and harsh self-criticism or hopelessness. Often in the form of major depressive disorder, persistent depressive disorder (dysthymia), perinatal depression, and depression that follows illness, injury or a major life change.
Grief and loss - Bereavement, and losses that are not deaths, such as a relationship, a role, an ability, or a future you had planned for. Waves of sadness and longing, difficulty accepting the loss, guilt, and pulling back from ordinary life. Where grief stays intense and disabling long afterwards, it may be diagnosed as prolonged grief disorder.
Sleep difficulties - Trouble falling asleep, waking through the night, waking too early, or waking unrefreshed, along with the daytime effects of fatigue, poor concentration and irritability. Often in the form of insomnia disorder, or sleep disrupted by worry, low mood, pain or shift work. Where a physical sleep disorder such as sleep apnoea may be involved, I will point you back to your GP.
Techniques I use
My approach is practical and collaborative. We start with what matters to you, and the therapy is shaped around that rather than around a fixed program. I draw mainly on four well-established approaches, usually in combination.
A) Acceptance and commitment therapy (ACT). Clarifying what genuinely matters to you, and building the willingness and flexibility to move towards it, including when difficult thoughts and feelings come along for the ride.
B) Behavioural therapy. Starting with what you do rather than with how you think. That might mean rebuilding activity and routine when low mood has shrunk your world, approaching avoided situations step by step at a pace you set, or changing the habits that keep a problem going. It is often the part of therapy that shifts things first.
C) Cognitive behavioural therapy (CBT). Looking at the patterns of thinking and behaviour that keep a difficulty in place, and testing out changes to them.
D) Decentering and mindfulness skills. Practical ways of stepping back from thoughts and reactions, and seeing them as passing mental events rather than facts, instead of being carried along by them.
What to expect
1. First session. We talk through what has brought you here, what you have already tried, and what you would like to be different. By the end we will have a shared sense of what we are working on.
2. The work itself. Sessions are usually weekly or fortnightly to begin with, then spaced out as things improve. There is no set number. Some people come for a handful of sessions with something specific in mind, others for longer.
3. Reviewing. We check in on how it is going, whether the approach is right, and whether continuing is useful. If something else would serve you better, I will say so and help you find it.
