Finding Help When You Need It You know that something isn’t quite right. Maybe you have been feeling low for a really long time. Perhaps the things that used to make you feel better are no longer working. You may be experiencing conflict or a breakdown in your relationships. Whatever it is, all you know is that you are not happy, and something needs to change. It’s not always easy to acknowledge that things in your life are not quite as you would like them to be. For some, this comes with a feeling of failure; why haven’t you been able to ‘win’ at life like everybody else seems to be doing? Sometimes there is a guilt that despite trying so hard, you don’t have the tools to help yourself. For others, there is the fear of opening a lifetime of worries, feelings and experiences that you have been working hard to forget or leave in the past. All these feelings are normal. You are not alone. Why Mental Health Should Be Treated Like Physical Health If you had a physical health problem, you probably wouldn’t think twice about going to the doctor and seeking help and support. Why don’t we treat our mental health in the same way? Sometimes life can throw some really challenging events at us, sometimes it is a gradual build-up of stressors and experiences that over the days, months and years become too much to manage on our own. However you have got to this point, there are people who can help. How to Find the Right Help for You So, you know you would like help, but how do you find it? How do you choose what will be right? The answer is to reach out; contact therapists, talk to them, ask all the questions you have, and get a feel for whether they are someone who will help you to feel safe enough to begin to lay down some of the heavy emotional burdens you have been carrying. A good therapist will assess your needs and take time with you to consider whether they can offer what you need, and if they can’t, they will signpost you to somewhere that can. A good therapist will be warm and open, they won’t pressurise you and they will place you at the centre of everything they do. The Importance of the Therapeutic Relationship One of the most important factors for effective therapy is the therapeutic relationship; the relationship between client and therapist. Therapy is a collaboration which is built on trust, empathy and non-judgement. Once that relationship is developed it creates a space where the client feels safe to share and explore, and the therapist can hold what the client brings. Spend time finding someone who can do all this with you, who will walk alongside you as you work through your problems, feelings and experiences. What to Expect Before Your First Session You’ve acknowledged you want some help and support, you’ve chosen your therapist and it’s time for your first session. How do you feel? Nervous; relieved; defensive; fearful; excited. All these emotions and more are to be expected before a first session. But therapy is about one step at a time, so take that next step into the session and begin your journey.

What to Expect in Your First Therapy Session If you have made the decision to come to counselling or therapy, you probably know that there are things you need to talk about. Knowing how to articulate those things, where to begin, or how to convey complicated experiences and feelings can feel really overwhelming, especially in your first session. For some clients, the first session feels like a release, and words pour out as months, years or sometimes a lifetime of feelings finally have a space to be shared. For other clients, the words can’t be found. Maybe they feel like the weight of what has happened is too much to put into a few sentences to a stranger. Sometimes the thought of finally talking about things that have been unspoken can by truly terrifying, because what will happen when those feelings and thoughts are out in the world? All of these experiences and anything in-between are common and understandable. So where do you begin? Understanding the Different Approaches to Therapy Therapy and counselling can come in many different forms. Each will have its own model and structure of working. For some, the first session will be a more formal assessment with directed questions which aim to uncover more about your background, what has led up to this point, and what the goals of therapy may be. Other models, such as person-centred counselling can have a more informal approach, where the client is in control of how the session unfolds and what they would like to bring. Either way, your therapist or counsellor has one main aim for that first session; to build trust. The Importance of Trust in Therapy In person-centred counselling the therapeutic relationship underpins everything that will happen in therapy, and as a client, you need to feel safe, accepted and heard in that first session. You can set the pace, share what feels appropriate and take time to allow the trust to build between you and your counsellor. I allow information from the client to unfold naturally, and allow them to choose where they would like to begin. If this feels uncomfortable for the client, then thinking about how it actually feels to be in the counselling session can be a good place to start. Often a client will have a complex history of experience, but that may feel too much as starting point, so beginning with the ‘here and now’- how are you being impacted in your life currently – can also be a useful way to ease into what a client has been experiencing. Similarly, thinking about what a client would like to be different can also help to uncover what some of the current issues or hurdles are in their life currently. What to Keep in Mind During Your First Session Crucially, remember that there is no ‘right answer’ to how a session should go, no expectation of how much will be shared, no judgement of how a client presents or behaves. One session is not going to ‘fix’ a problem, or provide all the answers, but if at the end of the session you walk out feeling like you were listened to without judgement, received an empathic response to what you shared and feel comfortable with the idea of returning again to continue building on what you started, then that is a successful session.

Hello Internet! As I write this, my first ever blog, I can feel own anxiety is rising! Yes, that’s right, we psychologists are no strangers ourselves to such visceral experiences. Why? Well, because like everybody we’re human. It is to be expected though, right? When we put ourselves in the ‘firing line’ so to speak, of other peoples’ gaze, evaluation, judgments, and possible rebukes, it triggers a primitive, protective response in us. The Roots of Anxiety This goes back a long way; when early humans were roaming the earth with sabre-toothed tigers and cave lions round every corner, being visible was a great risk to physical safety; every second counted when it came to surviving the predation of such beasts. We therefore developed a sophisticated alarm system to alert us to the dangers in the world. This, we now call anxiety. Modern Anxiety: The Same Alarm System, Different Threats Of course, there are no longer the same physical threats to survival that there once was, there are some to be sure, but most of our anxiety responses are now triggered by internal threats or relational conflicts, yet the purpose of anxiety in such contexts remains valid and the same – anxiety is our alarm system and our drive to action. So, anxiety serves two vital purposes in our lives, it tells us that there’s a problem and it tries to focus our minds towards solving that problem. So why do so many of my clients tell me they just need anxiety to STOP! Well, it’s understandable when we consider that anxiety feels… well, absolutely rubbish! Thoughts vs. Anxiety Common opinion holds that worrisome thoughts ‘are’ anxiety, but such thoughts might be better understood as our attempts to think our way out of anxiety (which of course doesn’t work and only serves to perpetuate it; hence people believe that thoughts are anxiety). In actual fact, anxiety is a physiological, bodily response – i.e. symptoms like muscle tightness, a roiling tummy, an urge to go to the toilet, a constricted throat, a dry mouth, dry eyes, excessive sweating, a tight chest, restless legs, going floppy and losing motivation, experiencing brain fog, ringing in the ears or tunnel vision. All these are anxiety symptoms and, like I said, they really do feel… RUBBISH! Our Natural Tendency to Avoid Anxiety It makes sense then that we would try to avoid such pain, if at all possible, right? Especially since ignoring these symptoms now does not result in being eaten by a sabre-toothed tiger or cave lion! So, over the millennia, we have learned as a species to quiet the bells of anxiety, to find ways to distract ourselves and thus avoid the pain that comes with it. This short-term solution can be helpful in making us feel better… in the short term. But, just like your bedside alarm clock, if you mute it, it will come back on after a time and get louder and louder and louder until you finally take notice. The Dangers of Trying to Eradicate Anxiety When anxiety gets louder, it gets more painful, and that is why in more recent times anxiety has become a mental health disorder, something problematic in people’s lives, and something that many clients and therapists are striving to eradicate from people’s experience.  To me this is utter folly – to try to get rid of somebody’s anxiety is a) simply not possible, and b) it would rob them of their drive and their alarm system. A Healthier Approach: Reclaiming Control Over Anxiety My approach is to help people to pay attention again to anxiety, to not be afraid of it, and to not shy away from the minor muscle tension that comes with the first whisperings of an anxiety reaction. If people can successfully pay attention to themselves again in this way, then they can reclaim control over their lives. Their anxiety response can then alert them to other feelings that need attending to, such as anger or sadness, and it becomes a useful tool in getting their needs met once again. I hope this initial blog helps in some way to develop your understanding of and relationship with your own anxiety, and I will endeavour to further harness my own to bring you more insights in future posts! Until the next time. Dr Steve Hoole CPsychol AFBPsS Clinical Psychologist & Director Talking Therapy North