How do Online Sessions Work for Schema Therapy?

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During this stressful time, many of us will be struggling with anxiety or low mood, especially if you are self-isolating or on lockdown, with few chances to leave the house. If you are finding it hard to cope during the coronavirus outbreak, first and foremost connect with your friends and loved ones.

Social distancing is, in my opinion, not the most helpful term right now. Instead, we should all be physically distancing but socially connecting – by phone, social media, Skype, Zoom or any other way that lets us stay in touch with those we love, while keeping them and ourselves safe.

If you need more help than that, do reach out to me or another mental-health professional, who can offer guidance and support during this hard time. I have long worked with clients online via Zoom. It also means I can help people all over the world, which is wonderful. I am offering both short-term and long-term therapy during the current crisis.

Here are a few guidelines about how online therapy works:

1. I use Zoom for online sessions – it has revamped its privacy/security recently, so I am confident it’s a secure and confidential platform for therapy. Using Zoom is very simple. Before your session, I will send you a link via email, which you click on to join an online ‘waiting room’. At the start of the session, I click on your name to begin our session, then lock the meeting to ensure complete confidentiality.

2. I will create a shared folder on Dropbox, so that we can share important documents like an intake form, or notes I want you to read after a session. This means that all communication is confidential (Dropbox also has strict security measures in place).

3. You may feel uneasy about having therapy online. But, having provided hundreds of online sessions over the years, I find it works very well for schema therapy. We get to see each other and hear each other’s voice. And clients tell me they feel safe and connected to me.

4. That said, we need to be flexible to make it work. Exercises like chair work are obviously a bit trickier online! But I do them, regularly, and will explain how to make them work. After the session I will send you an iZettle invoice, so you can pay quickly and securely. And that’s it!

If you have any questions about online session with me, email dan@danroberts.com or use the contact form to get in touch.

Warm wishes,

Dan

How to Manage Your Coronavirus-Related Health Anxiety

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Do you struggle with health anxiety? If so, you’re not alone. Millions of people around the world face a daily battle with this anxiety disorder. I often tell my clients that, if you’re prone to anxiety, your health is one of the easiest things to obsess about, because of course humans are vulnerable to health problems.

We all struggle with our health, dealing with everything from mild problems like the common cold to serious illnesses like diabetes and cancer. And we are all mortal, so have to accept that one day, our life will end. It’s natural — in some ways even logical — to worry about your health.

Now, of course, we are facing an unprecedented public health crisis. In the UK, as I write this over-70s are encouraged to self-isolate, many businesses have shut down and all schools are closing from tomorrow, we are all being encouraged to adopt social distancing and stay home as much as possible. And I’m sure the restrictions will get more and more severe.

The reality is that Covid-19 is a scary, unpredictable and long-term problem that we are struggling to understand and contain across the globe.

Kryptonite for the health-anxious

So I am anxious. My friends, family, colleagues and neighbours are anxious. Anxiety is a normal, healthy, proportionate response to a global crisis like this. It’s hard for everyone right now.

But I think — as well as the high-risk groups of people who are especially vulnerable to a serious reaction to the virus — this crisis is extremely tough on people with two types of mental-health problem: contamination-focused OCD and those with health anxiety (formerly known as hypochondria). I am going to focus on the latter problem in this story, but there is a huge amount of information about, and help with OCD on the MIND website, if you need it (mind.org.uk).

Health anxiety is one of the anxiety disorders, in which people develop an unhelpful preoccupation with their health. A useful definition I once read is: ‘The catastrophic misinterpretation of benign physical symptoms’.

That means that, if you have health anxiety, you will catastrophise — one of the common forms of unhelpful thinking styles treated with cognitive therapy — about benign physical symptoms. This means that, if you get a tension headache, you start Googling symptoms (always a bad idea!) and become convinced you have a brain tumour.

If your heart rate speeds up, because you’re stressed, anxious or engaging in physical exercise, you are 100 per cent sure you have a heart problem. You notice a tiny mole on your forearm and worry obsessively that it’s skin cancer.

Coronavirus-related anxiety

If this sounds familiar, I feel deeply compassionate for you right now. It must be hell. Every time you look at a newspaper, Twitter or your Facebook feed, you are confronted with frightening, doom-laden headlines about this awful virus that is sweeping through the global population. You, like so many of my clients right now, must be overwhelmed with anxiety.

But you can’t let anxiety dominate your life. This crisis is likely to go on for months, so you need to take swift and decisive action to help yourself. Here are three pieces of advice to get you through this:

1. Engage your rational brain

Because this all feels so threatening, the ancient, emotional parts of your brain have taken over — primarily your ‘threat system’, which is on red alert right now. This system triggers the fight-flight-freeze response to danger. If you’re super-anxious, you are in flight mode much of the time.

One answer to this is to use your rational brain — the frontal cortex — to calm down the parts that are freaking out. This virus is truly awful, but the vast majority of those who contract it will only develop cold- or flu-like symptoms, then make a complete recovery. Many health-anxious clients I have worked with are young, fit, healthy, often vegan and teetotal — some of the healthiest people I have ever met!

If that’s you, remember that it is overwhelmingly likely you will be fine, even if you get it. So stop catastrophising and take sensible precautions to minimise your risk of contracting the virus: social distancing, mask-wearing, regular hand-washing, and so on.

2. Breathe

When the fight-flight-freeze response has kicked in, your breathing goes haywire. Basically, you start breathing like a hot dog panting — rapid, shallow breaths that will make you feel dizzy, tight-chested and breathless. Not good, if you’re already worrying about a virus that targets your lungs.

So you need to slow your breathing right down, breathe abdominally, for roughly four seconds in and four seconds out. Do that for at least a minute, more if possible. I call this ‘compassionate breathing’, but it’s just deep breathing, so you can do it anywhere, any time if you need to calm yourself down.

Trust me: it’s awesome and it really works.

3. Get some help

Please don’t suffer alone. We are all struggling right now and need all the help we can get. There are plenty of charities set up to help with health anxiety and other anxiety disorders. Here are just a few for those living in the UK:

• Young Minds (youngminds.org.uk)

• Anxiety UK (anxietyuk.org.uk)

• OCD Action (ocdaction.org.uk)

If you need more help than this, I would recommend either cognitive or schema therapy. I have helped dozens of health-anxious people with both approaches and they are proven to be the most effective forms of psychotherapy for anxiety disorders. In the UK, you can get cognitive therapy on the NHS, but it will probably be a long wait. If you’re looking for a qualified private cognitive therapist, visit BABCP’s site (babcp.com).

If you would like schema therapy from me, use my contact form to get in touch.

So if you are having a tough time right now, know that help is out there for you. We will get through this. Humans are remarkably resilient. We will develop a vaccine and treatments for Covid-19 are already being trialled.

Wherever you are in the world, sending you love and warm thoughts from London,

Dan

Online Therapy Available During the Pandemic

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As we all find a way to manage the coronavirus pandemic as well as possible, I have moved all of my therapy sessions online. I now offer sessions via Zoom. This means I can offer help to people all over the UK, as well as those living anywhere in the world. I am offering both short-term therapy, to help people through the current crisis, as well as my usual long-term schema therapy.

This is an anxiety-provoking and stressful time for everyone. But it can be especially hard for people who already struggle with day-to-day anxiety, or have an anxiety disorder like health anxiety or OCD. If you have experienced trauma in your life, it may also be triggering unpleasant memories for you, or you may be struggling to cope with the flood of scary headlines about the outbreak.

Please take all sensible precautions to keep yourself and others safe and well, especially older people or those in high-risk groups.

If you would like to know more about how online sessions with me work, I explain all the details in this post. And if you would like help getting through this difficult time, email dan@danroberts.com or use the contact form to get in touch.

Warm wishes,

Dan