Psychotherapy

What I Have Learned from 30 Years of Studying Psychology

Image by Jr Korpa

As a psychotherapist, I have spent over 30 years learning about mental health, psychology and psychotherapy. During that time I have taken a deep dive into a number of therapy models, including:

  • Cognitive behaviour therapy

  • Compassion-based therapies like compassion-focused therapy and mindful self-compassion

  • Parts-based, transpersonal therapies like psychosynthesis

  • Trauma therapies, especially Janina Fisher’s trauma-informed stabilisation treatment

  • Somatic therapies like polyvagal theory and somatic experiencing

  • Schema therapy

  • Internal family systems

  • Mindfulness-based therapies such as MBSR and MBCT, as well as Buddhist psychology

I now integrate the best of these powerful, highly effective models into a unified treatment approach with my clients. Here are some of the key principles of my approach.

trauma-informed therapy

As someone who specialises in helping people with the impact of childhood trauma, I have come to understand that trauma is at the root of most psychological problems, such as depression, chronic stress or anxiety, eating disorders, addiction and substance abuse, low self-esteem and relationship difficulties. I am currently writing a book about healing trauma which will take readers on a step-by step guide to using an integrative approach to heal the wounds of a painful childhood.

After decades of research, including the groundbreaking Adverse Childhood Experiences Study, we now understand that most of the psychological problems people struggle with have their roots in trauma or neglect in childhood. These may be single-incident traumas like a car crash or natural disaster, but are more likely to be complex trauma, such as bullying in the home or at school; experiencing any kind of abuse; having a parent with substance-abuse or mental-health problems; being harshly criticised, feeling unloved or unvalued on a regular basis; growing up in a high-conflict home, or witnessing domestic violence; experiencing poverty, homelessness or frequent upheavals in childhood; experiencing any kind of discrimination, especially racism, sexism, homophobia or transphobia.

Whatever you may be struggling with, it’s likely that childhood trauma or neglect is the root cause of your problems. And this needs addressing, which means you need a trauma-informed approach. Linked to this is a thorough understanding of the nervous system, as trauma dysregulates your nervous system and other systems in the body. So it’s helpful to understand that through the lens of somatic approaches like polyvagal theory or Peter Levine’s somatic experiencing. I have created a wide range of breathwork, meditation and guided-imagery practices for my Insight Timer collection, many of which will help you calm, soothe and regulate your nervous system. And these approaches form the foundation of therapy, before we move on to trauma processing.

an attachment-based approach

Most of the trauma we experience as children is relational, meaning we are hurt by those who are supposed to love, protect and care for us. Very sadly, most abuse happens within the family, despite the scare stories of ‘stranger danger’ published in the media. And more subtle forms of emotional neglect can be extremely painful for children, such as having a parent who is chronically depressed, so – through no fault of their own – struggles to attune to your needs in the way all children require to develop a healthy mind and body.

A core need for all children is secure attachment with their caregivers – feeling safe, protected, loved and cherished by their parents, or other key family members if they are raising the child. This secure attachment in childhood translates to a secure attachment style, which we know around 50 per cent of adults possess. The other half of the population are mostly either anxious or avoidant, both of which create problems in forming healthy, nourishing relationships.

If you have an insecure attachment style – like most people seeking therapy – you need an attachment-based therapy, which will help you learn to feel safer and more secure in relationships, bit by bit. Schema therapy is the gold standard of this approach to therapy, so I integrate all the richness, wisdom and practical tools from this model into my work.

a parts-based model

One of the major revolutions in psychotherapy began in the late 1980s, when a number of parts-based therapy models were developed. These include schema therapy, internal family systems, Janina Fisher’s approach, Gestalt therapy and many others. My approach is also a parts-based, because it’s clear from a neurobiological understanding of the brain that your mind, and mine, is formed of a number of parts – this is known as ‘multiplicity of self’. It means that you have parts, like the Inner Critic or Inner Child, who either hold painful beliefs, memories and experiences from difficult times in your life, or work to keep those hurt young parts safe.

My work with clients draws especially on internal family systems, because it’s a warm, compassionate approach to healing these hurt and hardworking parts. But I strongly believe that no one model of therapy holds all the answers, so its better to draw from a wide range of models, creating a bespoke treatment for each individual client. I have found this to be the most powerful way to heal trauma with my therapy clients and have taught this approach to many other mental-health professionals, in my supervision and wider teaching.

Compassion at its heart

Finally, my approach involves a strong emphasis on learning self-compassion, because this is perhaps the most important skill you can learn – and especially if you experienced childhood trauma. Most of my clients are highly self-critical, with negative and self-lacerating beliefs about not being good enough, being dislikable or unlovable. None of these things are true, but are unhelpful ways of thinking about themselves they learned as a child – what are called ‘schemas’ in schema therapy.

Any effective therapy involves learning a new story about your life, one which is kind, compassionate and realistic, rather than highly negative and demeaning. Learning to think differently about yourself is a key part of any good therapy – and learning to be self-compassionate is an antidote to the noxious and harmful ways of thinking you developed as a child.

If you would like to know more about my approach to therapy, do sign up for my newsletter using the form below – you will get to read my latest blog posts, which are enjoyed by half a million people a year. You will also be the first to hear about my new courses, webinars and workshops, as well as my new book, when it is published in 2026. Also check out my Insight Timer collection, for a wide range of practices, most of which are free or donation-based.

I hope you find the help you are looking for from me or the many brilliant therapists and teachers globally, all of whom are dedicated to helping heal people struggling with the legacy of trauma. As I always tell my clients: Whatever you have been through in your life, it is never too much and never too late to heal.

Love ❤️

Dan

 
 

Would You Like Help With Your Worry and Anxiety?

Due to unforeseen circumstances, this event has been cancelled. If you were interested in attending, do book the online version of this workshop, which will run on 10th December 2022. Bookings for that workshop open in November. We apologise for any inconvenience caused.


Coping with Anxiety: How to Worry Less, Feel Calmer and More at Peace features teaching, powerful exercises that will help you feel calmer and more relaxed, and the chance to put your questions to Dan Roberts, a leading expert on trauma and mental health.

In this powerful, highly experiential webinar you will learn:

  • Why high levels of anxiety are a common problem for people with a trauma history – and how that’s linked to a ‘dysregulated’ nervous system, as well as elevated levels of ‘stress hormones’ like adrenaline and cortisol in your bloodstream

  • How anxiety is the brain’s ‘alarm’ emotion, warning you that something bad is about to happen and that you should do something, immediately, to keep yourself safe

  • Why anxiety is linked to the fight-flight-freeze self-protection responses – useful for escaping from a hungry lion, but not if you’re sitting at your desk in a quiet, safe office

  • Simple, evidence-based strategies to calm your anxious inner child, quickly and effectively

  • Why anxiety (an emotion) and worry (a thinking process) are inextricably linked – and how to reduce both overwhelming emotions and unhelpful thinking

  • Key experiential exercises – such as Compassionate Breathing and 4-7-8 Breathing, guided meditations and imagery – you will learn to help you cope with your anxiety, reduce unhelpful worry and feel calmer and more in control

  • And throughout the day, you will get the chance to put your questions to Dan Roberts, Founder of Heal Your Trauma and an expert on trauma healing and managing anxiety

Don’t miss this chance to learn from a leading trauma therapist and expert on mental health and wellbeing – watch the video for more information and book your place now using the button below.

Warm wishes,

Dan

 
 

The Story of You: What You Needed and (Probably) Didn’t Get as a Child

Image by Kelly Sikkema

So, you were born. And like all babies, you were beautiful, innocent and pure. You were like a little seed, packed full of energy, primed to flourish and grow. But to do that you needed certain nutrients like food, water, air and warmth, of course, but also things like love and safety, to feel cherished and valued for the little miracle that you were.

As well as all the basic ingredients you needed to nourish you day to day, what little you needed most was to be loved, held, whispered and sung to, told stories of who you were and how you came to be here. You needed to feel your mother’s skin on yours, your father’s strong arms as he rocked you back to sleep.

We call experiences like this attachment and it is so deep, so powerful, hard-wired into every human brain. You needed a safe, secure, reliable attachment first to mum – who carried you in her body for nine months, gave you life, fed and cared for you at your tiniest and most vulnerable – and then dad, siblings, grandparents, aunts and uncles, cousins, school friends and so on, out and out for the rest of your life.

Our first and deepest attachment

But for most of us this starts with mum, our first and most important caregiver, who should love us fiercely, viscerally, as if we were part of her, because we once were. And when this goes as it should, it feels wonderful – so good in fact that we call it ‘attachment bliss’ – being held and stroked and fed and soothed and cherished. And this creates, in us, a powerful feeling, in our bones, that we are good, lovable, worthy of kindness and respect.

So that’s how it should be – and for some lucky people, that’s how it is. But for many of us, it doesn’t work like this. Something goes wrong, somewhere – either very mildly wrong, or more seriously. And if it’s mild, and we have enough love, enough safety, enough nutrients to feed our growing brain and body, then we come out of it fairly intact. We may be anxious, or get depressed from time to time, but mostly we’re OK, able to do all the normal stuff of everyday life and be happy, enough, most of the time.

And for some of us – in fact, far too many of us – the things that went wrong were much worse than this. And they happened not just once, but over and over, throughout childhood, one bad thing or lots of bad things, one after another. And if this is you, you might know what these things were, or just have a vague inkling that all was not well. Either way, what I’m saying resonates somewhere inside and you’re thinking, ‘Yes, that’s how it was for me.’

If that’s the case, I am truly sorry, because I know that you will be left with wounds. And one of the deepest of those wounds is that you will think you deserved it in some way, that you were a bad person, or somehow dislikable or unlovable. Because that’s what children do – they make it about them, because it’s too scary and threatening to think that the people who were supposed to love and protect you, were in fact the ones who hurt you. That’s too much for a child’s brain to comprehend, so they go, ‘Well it can’t have been their fault, so it must have been mine. I’m bad. I’m naughty. I made all the bad things happen and deserved them.’

None of this is your fault

And here’s where I really need you to concentrate. Take in these words, because they may be the most important thing anyone has ever said to you. And that’s this: none of those bad things that happened were your fault. You didn’t do anything wrong. You were just that sweet, innocent, pure little baby who was born into a bad situation.

See you think you’re a bad person, but you’re not. You are a good person that bad things happened to.

That’s so important I’m going to say it again. You think you’re a bad person, but you’re not. You are a good person that bad things happened to.

And somewhere inside you is that sweet, innocent, lovable little boy or girl. They still live in your mind and body and nervous system, whether you know they are there or not. And they are the part of you that needs to hear this the most, because they hold all the memories of bad stuff and how it felt, and what they thought, and all the other stuff that goes with that.

‘I am not what happened to me. I am what I choose to become.’

Carl Jung

So let them know that they are not bad, or wrong, or naughty, or anything other than a beautiful little child, who deserves to be loved and cherished, and held, and made to feel good about themselves. Because that’s what we all want – it’s what we’re born for, really, to feel that from other people and to give it back to them. It’s why we’re all here.

I hope this helps you think a little differently about your life, about yourself, about why you struggle as you do. As ever, also know that these wounds can be healed, with enough time, work and loving, compassionate support.

And I will be here, every step of the way, giving you every ounce of knowledge, wisdom, guidance and support I possess.

Warm wishes,

Dan

PS I have recorded this as a talk for my InsightTimer Collection – click on the button below if you would like to listen (for free) now.

 

Why You Keep Falling in the Same Hole – and How to Stop

Image by Ian Taylor

My first counselling training began almost 30 years ago – way back in 1994. Although I was very young (probably a bit too young, in hindsight), I absolutely loved it. The three-year training, in Psychosynthesis – a humanistic/transpersonal model – was so stimulating and exciting. I had never experienced anything like it.

And I remember one of the trainers reading a poem to us and then using it as a metaphor for therapy, which has stuck with me ever since – I recently tracked it down and learned that it was Portia Nelson’s There’s a Hole in My Sidewalk: The Romance of Self-Discovery. I have used this poem/metaphor with hundreds of my clients, so think you will find it helpful. Here’s how it goes.

Part 1: Falling in the hole

Imagine that you’re walking down a road on a lovely sunny day. You feel fine and are enjoying your walk, not heading anywhere special, just ambling down the road. Then, bang. Without warning, you fall into a huge hole in the road.

You lie there, bruised and winded at the bottom of the hole, thinking to yourself, ‘What the hell was that? Where did that stupid hole come from?’

Eventually you manage to climb out of the hole and go on your way, shaken, sore and confused.

Part 2: Falling in the same hole

Months go by. You walk down the same road every day. And every single day you fall into the same damn hole. It’s like Groundhog Day – you never see it coming and it always takes you by complete surprise. You start really hating that hole…

Part 3: seeing the hole but still falling in

Eventually, something changes. Now when you walk down that road, you realise that the hole is there. You even see it as you walk towards it, but – and this is the most maddening bit – you still fall in! And when you find yourself, battered and bruised at the bottom of the hole, you think to yourself, ‘This is making me crazy now! How can I see the stupid hole but still fall in every time? Argh! So annoying!’

Part 4: Hole-enlightenment day

This goes on for way too long. You now hate the hole with a deep and abiding passion. Until, one day, something miraculous happens. On this special day, you walk down the usual road. You see the hole coming. You walk closer. And closer. And closer. Until, just as you’re about to fall in again, you think to yourself. ‘Wait a damn minute. I know you, hole! And do you know what? I have had enough of the falling. And the bruising. And the being shaken.’

So you do something quietly wonderful. You see the hole, decide to walk around it, then do just that. On you go with your journey, feeling deep-down-in-your-bones happy and proud of yourself.

So what does all that mean?

Here’s why I have told that story hundreds of times over the years. It’s because this is how the therapy process – and any kind of personal growth – works. At first, you get triggered by things you don’t even know are there, or are triggers, or even what a trigger is! So of course you keep falling in the same wretched holes, because you don’t know they exist.

Your holes might be the same as mine, or they might be different. So one of my holes/triggers is narcissistic people, especially men. People with this kind of personality can often be harshly critical, or demeaning, or shut you down rudely and insensitively. And one of my family members did that to me a lot as a child. So just being around a person like this is triggering for my young, hurt parts – because they expect to be hurt again.

It took me a long time (and a lot of therapy) to learn this, but now I know that this is one of my holes so I – mostly – manage not to fall in.

Achieving hole-enlightenment

Of course, the oh-so-glorious day is the one where you see the hole but manage not to fall in this time, instead walking around it and carrying on, with a huge smile on your face. But that takes time. It takes a lot of learning. A great deal of compassionate support. And all of this is especially true if you have a trauma history because, sadly, you will have more holes than most people, they will be bigger and deeper, and it will be even harder to learn not to fall in.

But, as I am always explaining in these posts, just because it’s harder for you doesn’t mean it’s impossible. I passionately believe that everyone can heal, including you. That’s because we have a range of life-changing, trauma-informed therapies at our disposal now, as well as a wealth of knowledge about the mind, brain, body and nervous system, what happens to them during trauma – and, crucially, how to heal those wounds.

If you would like to know more about all of this, start by reading my website and Heal Your Trauma Blog, which contains a huge amount of information about trauma and mental health in general. You could also come along to my first Heal Your Trauma webinar, What is Trauma and Can it Be Healed?, on Saturday 26th February, 2022. You can book your place, for just £49, using the button below.

I hope to see you there – and good luck with those holes!

Warm wishes,

Dan

 

Watch My New Heal Your Trauma Video: What is Trauma?

We hear the word ‘trauma’ used often these days – in the mainstream media and on social media, by experts, celebrities and normal, everyday people who have gone through traumatic events. But what do we mean by psychological trauma? Which kinds of experiences can be traumatic for us? What are the short- and long-term effects of those experiences? And, crucially, can traumatic wounds ever be healed?

In the first of a series of short webinars I will be recording for my YouTube channel, I attempt to answer the above questions. In this 20-minute webinar I explain:

  • Why I think that the standard clinical definitions of trauma are too narrow

  • Why traumatic events don’t necessarily cause post-traumatic stress disorder (PTSD) or complex post-traumatic stress disorder (CPTSD)

  • How trauma affects every level of your mind-body system

  • And, most importantly, why it is never too much and never too late to heal, whatever you might have gone through and however wounded you may be as a result

I am currently working on a series of full-length webinars for my Heal Your Trauma project, which you will be able to watch either live, or access the recording to watch at a later date. In the meantime, do check out my YouTube channel, listen to my guided meditations on Insight Timer, and you can sign up for my newsletter, using the form below, so you can be the first to hear about these resources as I make them available.

I very much hope you enjoy the webinar and find it helpful.

Warm wishes,

Dan

 
 
 

Which Part of You is Driving Your Bus?

Image by David Henderson

When my clients tell me, ‘I really hate myself today!’ or ‘I need him to call me, even though I know he will just hurt me again,’ I often ask them, ‘Which I?’. So, which I hates and which feels hated? And which I is so attached to this guy that she doesn’t care if she’s hurt – or perhaps finds that hurt familiar, because it reminds her of her painful relationship with mum or dad.

And people often look at me with a bewildered expression on their face, because we are all used to thinking of ourselves as just me. So of course, I feel like I am Dan all the time. I think Dan thoughts and have Dan experiences and everyone who speaks to me calls me Dan. Just me. Just one, homogeneous self.

We all have many parts

But we now know that this is not how the human brain works. Your brain creates many selves, which fulfill different roles in your internal system. For example, you may have a self that goes to work every day, even when you would rather stay in bed, and can be assertive and deal with your prickly, critical boss. But you have another self that is much less confident and secure when you are in romantic relationships (which is, of course, deeply frustrating and mystifying! ‘Why am I so confident at work but crumble when my boyfriend’s mean to me?’).

You find yourself feeling and behaving differently when you go back to your family home, when you are with this (kind, supportive) or that (abrasive, critical) friend, and so on. You have many selves, or parts (and in schema therapy we call these modes). This is just how the brain works, even if we are fairly healthy and high-functioning.

But if you have experienced trauma, your brain will have created many more parts to help you cope. One part may hold particular traumatic memories, enabling you to get on with school, or work, without being flooded by painful memories and feelings all the time. Another part makes you drink to numb painful emotions. Another might push you to self-harm, or restrict food, or whatever it is you need to get through the day.

We know that trauma survivors have many parts and that these parts might be more separate and distinct than for those lucky enough not to have experienced trauma. At its most extreme, this separation of parts leads to a dissociative disorder, where people frequently move between their parts, with little awareness of this change or the other parts in their system, which clearly makes life very difficult. This can lead to ‘dissociative amnesia’, where people lose parts of their day, not remembering where they have been or what they were doing.

One bus, many passengers

Whether you are a trauma survivor or not, it’s helpful to know the bus metaphor, which my clients really like. It goes like this… There you are, driving along, with all of your parts on board a bus. There may be one or more child parts, some happy, some sad, some running around and causing all sorts of trouble. There might be a Critical Part, giving you a hard time about something or other.

Maybe there is an avoidant part, who doesn’t want to be on the bus at all – too many people! Too much noise! Or even an entitled part, who thinks he’s pretty great (certainly better than all the other loser parts on the bus). The point is, all of these parts are on your bus. And you need to make them all welcome, whether you like them or not, because they’re not getting off any time soon!

But there is only one part you want driving the bus – and that’s your Healthy Adult. He or she is the strong, resilient, mature, wise part that knows what’s best for you. And loves you – even those parts of you that are a bit hard to love. And your Healthy Adult is, or should be, in charge of all the other noisy, opinionated, impulsive parts – like the teacher in a nursery, or parent of a large family. The kids can have their say, but mum or dad should be the one making all the big decisions.

Don’t let these guys drive

Because if the angry part if driving, you might find yourself letting your irritation bubble up and snapping at your kids, which feels horrible. Or if the part who wants you to drink is at the wheel, you find yourself in the pub, alone, on a sunny Saturday morning, drowning your sorrows. And if the Critical Part is driving, it will park up, turn around and berate you about your latest ‘failing’ for an hour.

You get the idea. All of your parts are welcome to be passengers on your bus. They can all shout out ideas, opinions, suggestions. And your Healthy Adult listens, takes note, then he or she makes the decisions. Wisely. Calmly. Sensibly. And so you drive off down a road that leads to a happier, more fulfilling life – not the familiar roads that end up in dead ends or dark alleys.

If you want to know more about how to help your Healthy Adult take charge, do keep reading my blog (for example, here’s a post about using mindfulness to quiet a noisy mind), see a good schema therapist; or check out Internal Family Systems therapy, another great model which is all about getting to know, integrate and have compassion for every part in your system.

Warm wishes,

Dan

 

Why Every Part of You Deserves Love and Compassion

Image by Jude Beck

Image by Jude Beck

One of the key discoveries in neuroscience over the past 20 years has been that we are not one, homogenous self – we are not just ‘Sally’ or ‘Jim’, even though it very much feels that way. Instead, this new theory argues for a ‘multiplicity of self’, which basically means we have lots of different parts of our personality. And in some ways, this is just common sense.

You might have a part that wants to diet and lose weight, but another part that really wants that extra bowl of ice cream, or slice of cake. You may have a part that hates all the boring, humdrum stuff of daily life (vacuuming, washing up, doing your tax return) but another part that helps you get all that stuff done, however much you don’t want to.

Disliking parts of yourself

In schema therapy, we call these different parts ‘modes’. In other models of therapy, they are called parts, sub-personalities or self-states, but it’s essentially the same thing. And something I often see in my therapy practice is that people might dislike or even hate some of their modes, while liking others. For example, we might get really frustrated with the mode that has us reaching for the ice cream, even though we’re desperate to lose weight and know we will feel guilty and ashamed after wolfing another bowl.

We may also hate the part of us that makes us feel vulnerable, or overwhelmed with emotions when we’re at work and want to appear cool, calm and professional. In schema therapy, we call this mode the Vulnerable Child; and we then name it ‘Little Sally’ or ‘Little Jim’. We all have this part – I have a Little Dan inside me – and it is the emotional, vulnerable part of us, that gets triggered by stressful or threatening people or events.

This part of you also holds a lot of upsetting memories from your childhood, as well as images, body sensations, emotions and beliefs. For example, your little self might believe ‘I am worthless’ or ‘I am unlovable’, because that’s how you felt as a child. Nobody wants to think that way, or feel painful emotions like sadness, anxiety or shame that these beliefs might trigger in you. So you may try to ignore this part, or detach from it and all those upsetting feelings, shutting it away in a part of your brain you try hard to avoid.

Self-compassion is a superpower

But here’s the thing – whether you love, hate or ignore this part of you, it’s always there. As I often tell my clients, it’s like disliking your left hand. How ever much you might hate it, find it annoying, want to get rid of it, your hand is still there! So it’s much better to develop compassion for this part (and all other parts) of you. There is a huge amount of research now showing that self-compassion is a superpower when it comes to healing past hurts (if you’re interested in that, check out Kristin Neff’s work at self-compassion.org – she is the world’s leading researcher/expert on self-compassion).

Sadly though, it’s not easy to be compassionate to yourself. You may have been taught as a child that this was weak or self-indulgent. If you experienced trauma when you were young, this may be especially hard, as you learned to cope by shutting that little part of you away in a room somewhere, so the last thing you want is to think about him or her, let alone be kind to that part of you.

But here’s a technique to help you along the path to greater self-compassion. As ever with techniques I will teach you, there is no right or wrong, no doing it well or badly – just have a go and see what happens.

  1. Change posture. Let your shoulders roll back so your chest is open. Then lengthen your spine – sit upright but relaxed, with your head, neck and spine in alignment.

  2. Breathe. Take deep, slow breaths in and out — roughly four seconds in, four seconds out, but find a number that works for you (two in, two out; three in, three out…). We want nice diaphragmatic breathing, so let your stomach rise and fall with each breath. This activates your parasympathetic nervous system, which in turn activates the ‘rest-and-digest’ response, the opposite to fight-flight-freeze.

  3. Use supportive touch. Gently place a hand over your heart, touching yourself the way you would a friend who was upset — in a friendly, supportive manner. Feel the warmth under your hand and imagine it trickling down until it reaches your little self inside. Imagine that’s a warm, kind, healing energy that soothes this frightened or upset part of you.

  4. Add compassionate self-talk. Now talk to your little self the way you would to that troubled friend. Try to use a voice tone that’s warm, slow and reassuring. Say things like ‘Oh, Little Sally/Jim, I know you’re struggling right now – I really see how scared/upset/angry you are. But I want you to know that you’re not alone. I’m here with you. I care about you. I’ve got you. And we will get through this together...’

Try using this technique every time you feel hurt, sad, upset, anxious or otherwise ‘triggered’ by life events. As with any technique, remember that it may take time to be helpful. It’s like yoga or meditation – there’s a reason they call those having a ‘practice’. So practice every day until it starts to help you feel kinder to and more accepting of yourself.

Warm wishes,

Dan

Online Therapy Available During the Pandemic

Image by Jud Mackrill

Image by Jud Mackrill

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

 

What Are Unhelpful Thinking Styles in Cognitive Therapy?

Image by Tachina Lee

Image by Tachina Lee

Although difficult life events such as financial setbacks, divorce or family conflict are hard for anyone to deal with, you make these events either easier or harder to deal with because of your thoughts and beliefs about them. This is the basic principle in cognitive therapy, which is why cognitive therapists such as myself place so much importance on understanding the way people think, especially when they are upset.

If you can become aware of your automatic thoughts (which run through your head all day, providing a commentary on things you see, say and do) you can then start to identify unhelpful ways of thinking and try to change them.

What are negative automatic thoughts?

Negative automatic thoughts, or NATs, are the ones most strongly linked to unpleasant feelings like anger, hurt or anxiety. For example, when you feel angry you may be thinking someone has disrespected you, or endangered you or your loved ones in some way. When you are anxious, you may be worried about future threats such as redundancy or health problems.

Either way, in cognitive therapy we see the NATs as the source of your problem, because they are often exaggerated or based on interpretations, judgements or perceptions rather than concrete evidence.

It's also a vicious circle, because when we are upset the volume of NATs increases and we are more likely to use unhelpful ways of thinking rather than perceiving things as they are. Everyone does this, to a greater or lesser extent, and we all tend to use certain kinds of thinking more than others.

If you want to change unhelpful ways of thinking, identifying your own commonly-used thinking styles is a good place to start. Take a look at the following list and see which seem familiar to you.

Unhelpful thinking styles

1. All-or-nothing thinking. This is when you look at things as absolutes: good/bad, success/failure, black/white. There's no room for shades of grey. 

Examples: If I don't get an A on this test I'll be a total failure. Second place is for losers. 

2. Catastrophising. Exaggerating how bad things have been or will be, using words like ‘awful’, ‘nightmare’ or ‘disaster’.

Examples: If she breaks up with me it will be a nightmare. God, this party is bound to be a disaster.

3. Overgeneralisation. You view a single negative event as a never-ending pattern of defeat, or take one situation that doesn't work out to mean that life is always this way. 

Examples: That dinner party didn’t go well – I must be a terrible host. My partner seemed really grumpy with me last night – she’s obviously going off me and thinking about ending it. 

4. Mental filter. You dwell on the negatives and ignore the positives. So, if your university tutor gives you a glowing assessment including one mild criticism, that’s what you fixate on. 

Example: My appraisal seemed to go well, but all I can think about is that criticism of my grammar.

5. Discounting the positive. You reject all positive experiences, compliments or praise by telling yourself, ‘They don't count’, or ‘They're just saying that to be polite.’ 

Examples: That’s really kind, but anyone could have done it. We did get the best sales figures ever, but it’s all down to my team – I didn’t have much to do with it.
 
6. Jumping to conclusions. Making assumptions with little or no evidence, in two ways:

a) Mind reading. You assume you know what people are thinking – and it’s usually negative.

Examples: I know this girl thinks I'm boring. I’m sure they’re judging me behind their smiles.

b) Fortune-telling. You think you can predict the future – and assume things will turn out badly.

Examples: I definitely failed that test. I’m bound to be the one who gets made redundant.

7. Permission-giving thinking. Finding excuses to do something that provides short-term pleasure or relief but causes long-term difficulties. 

Examples: I’ve had a really stressful day so I deserve another whisky. I feel a bit down today so I’ll buy that dress/those shoes/that flatscreen TV and worry about it later.

8. Emotional reasoning. This is when you assume something is true because you feel it so strongly, assuming that your negative emotions reflect the way things really are. 

Examples: I’m so anxious I just know this plane will crash. I feel so jealous, I know he’s cheating

9. Should statements. Placing excessively harsh demands on yourself, others or the world by using the words ‘should’, ‘must’, ‘have to’ or ‘ought to’.

Examples: I should be happier, what’s wrong with me? I have to lose 10lb or I’m pathetic.

10. Labelling. Calling yourself or others names like ‘idiot’, ‘failure’ or ‘bastard’.

Examples: I’m rubbish at maths – I’m such a failure. That Mrs Jones is such a witch. 
 

Warm wishes,

Dan

 

The Anger-Management Skills Everyone Needs to Know

Pick up a newspaper, watch a movie or the TV news and you'll get the message, loud and clear, that anger is a Very Bad Thing. Road rage, desk rage, trolley rage – if we believe the media then anger is scary, destructive and something we should avoid at all costs.

In fact, the problem is not anger, it's aggression: the unhealthy distortion of a perfectly natural emotion. Like sadness, fear or love, anger is neither good nor bad, it just is.

The problem comes when you express anger in one of two dysfunctional ways: you become aggressive and struggle to control your angry outbursts, using threatening language and behaviour to exert control over others.

When you’re seething inside

Or passive, becoming scared of anger – both your own and other people's – meaning that you give away your power, struggling to impose yourself on the world or fight back when bullied, even though you might be seething inside.

Both distortions of anger can be extremely damaging. The first damages those around you, as you attack or intimidate them. Eventually, of course, if you keep lashing out you cause problems for yourself too – when your destructive behaviour gets you sacked, divorced or arrested.

If you belong to the second group, you mostly hurt yourself – bottling up your anger causes stress, anxiety, depression, cardiovascular disease, high blood pressure, stroke... the list goes on. 

Assertiveness, not aggression

Either way, you need to learn how to express anger cleanly and healthily – responding with appropriate, proportionate anger in situations that demand it (a rude co-worker; a bullying spouse; a salesman trying to rip you off). Anger gets a very bad press, but if felt and expressed healthily it's a great source of power and strength. The whole evolutionary purpose of anger is to protect yourself and those you love from attack. So the key is to be assertive, not passive or aggressive.

Some of humanity's greatest leaders have been the living embodiment of assertiveness, like Gandhi or Martin Luther King. Both practised non-violence, but transformed the lives of millions of people through sheer determination: they could not be bullied or intimidated, and maintained great dignity in the face of brutality and aggression.

If you would like to be more assertive, next time someone upsets you try this exercise:

1. Get the person's attention. This won't work if they're reading the paper or fiddling with their Blackberry.

2. Describe the behaviour you found difficult. Do this without personalising it or making accusations. Just stick to the facts: 'In that meeting you kept interrupting, talking over me and dismissing my ideas.'

3. Tell them how it made you feel. Use 'I statements' and take responsibility for your feelings: 'When you constantly interrupt me I find it frustrating and annoying.' Avoid emotions like anger, hurt or jealousy, because these will undermine your attempt to be assertive.

4. Check your interpretation and ask them to respond. Your interpretation of events may have been completely inaccurate, so it's very useful to check them against reality. 'Do you think you interrupted a lot? Did you feel dismissive of my ideas?'

5. Listen to the other person's response. Try to be non-defensive (this can be hard, but it will really help) and expect their interpretation to be different than yours. That's OK – they are entitled to their opinion, but you don't have to accept it.

6. Tell them how you would like it to be. This means expressing preferences ('I would appreciate it if you stop interrupting me in meetings'), not demands ('I'm sick of you interrupting – don't ever do it again!').

Of course, this is a bit of a lengthy process. Once you've got the hang of it you can boil it down to a much shorter exchange. And if you do this, regularly, you'll be amazed at the difference it makes to the way you feel and the relationships with your partner, family and colleagues.

Because it's so important, I would like to repeat this: expressing your anger healthily does not mean attacking anyone else, either verbally or physically. That is both unhealthy and destructive for all concerned. Managing your anger is about finding ways to be more assertive, expressing what you really feel and need without lashing out or stuffing your angry feelings.

Warm wishes,

Dan

 

Healthy Ways to Release Your Anger

Everybody gets angry – it’s a normal human emotion, like sadness, fear or joy. And there is nothing wrong with anger, despite its bad reputation and the damage it can cause. Like all emotions, the problem is not the anger, but the ways we either try to suppress and swallow it, or let it come spilling out, harming ourselves and those around us.

One of the main lessons I teach my clients in schema therapy is how to feel, express and so release their anger. And that’s not easy, because most of us have a problematic relationship with this most volatile of emotions – we may have grown up in a family where anger was never permitted expression, so we learned that anger was scary and shameful, to be kept inside at all costs. This means we now swallow our anger, which is not good for our health, physical or mental.

Or we might have grown up in a family that expressed anger too freely or even violently, with lots of screaming, breaking things or hitting. So again we are now probably afraid of anger, seeing it as threatening and unsafe, because we associate bad things with it. We may either have learned to hold it in, or followed our family’s example and now explode all over the place (using attack as the best form of defence against other people’s threatening behaviour), raging at other drivers or screaming at our partners/kids. This too is not good.

Healthy anger-release

I only have two rules for anger expression with my clients:

1. When expressing anger, they don’t hurt themselves.

2. When expressing anger, they don’t hurt anyone else.

Bearing these rules in mind, here are two ways to let your anger out safely and healthily (releasing all the energy from your Angry Child mode, which is the part of you that is so furious). First, try writing an angry letter to the person that has hurt or upset you. This may be your boss, partner, friend, colleague – or a person from the past, such as a critical parent. Write it on a blank Word document, allowing yourself to say whatever you need – swear as much as you like, use capitals and exclamation marks. Don’t censor in any way. When you’re done, print the letter and tear it into tiny pieces or burn it, imagining all that hostility and frustration leaving your body as you do. (And remember this letter never gets sent! It’s just for you and to release all that bottled up anger energy).

Second, get a towel and twist it until it’s really tight. Then keep twisting, saying ‘I am so angry with you!’, ‘I am so *!**!** angry with you!’ over and over, twisting the towel util your arms get tired (this should be hard work!). Make sure you stick with ‘I’ statements and the way they have hurt or upset you, rather than just blaming or attacking. You will eventually find that all the anger drains out of your body and you feel tired. And other feelings might bubble up too, like hurt or sadness. Let them be there and have a cry if you need to. This will help you feel better (and be soothing for your Vulnerable Child, which is the part of you that feels all the hurt, pain or fear that lies beneath the anger).

Warm wishes,

Dan

 

Why Exercise is Key for Good Mental Health

Image by Sporlab

Image by Sporlab

Most psychological problems – such as chronic stress, anxiety or depression – will require some kind of psychological treatment, especially if they persist over time. But it's easy to underestimate the impact of direct physical interventions on psychological problems.

Partly, of course, this is because the whole separation of mind and body is an artificial one – your mind is the product of your brain; hormones play a key role in regulating your moods; psychological problems such as stress and anxiety have a whole range of physiological symptoms... In reality, your mind and body are inextricably linked, with an exquisitely complex feedback system between the two.

So it should come as no surprise that regular physical exercise is key to good mental health. Think of exercise in two main areas: cardiovascular and relaxing. Cardio exercise such as cycling, dancing, racquet sports, football, brisk walking or swimming, weight training or martial arts burns off hormones such as adrenaline and cortisol that are produced when we are anxious or stressed.

Just 20 minutes of moderate exercise gives you a shot of endorphins, which help you feel happy and calm; and regular cardio exercise is proven to be just as effective as antidepressants for mild to moderate depression (and with no nasty side effects).

Stress-relieving exercise

Relaxing exercise includes yoga, tai chi, gentle swimming or slow walking and is an excellent stress-reliever, especially if you do it in a green space, such as your local park. This kind of exercise activates the relaxation response, which balances out the stress response and helps you feel calmer and more relaxed. If you are suffering from depression, you may lack the energy to do more vigorous exercise, but it's really important to do something even if it's just a walk round the block.

So if you're stressed out, struggling with an anxiety problem or depressed, remember that exercise will really help – and if the problem is short-term, it may be all you need to regain your equilibrium and feel better, so why not give it a try?

Warm wishes,

Dan

 
 

Acceptance Versus Change in Cognitive Therapy

Image by Ross Findon

Image by Ross Findon

A common dilemma for people engaged in cognitive therapy is understanding when to try and change a thought, behaviour, feeling, situation, relationship, etc and when to accept it. One way I explain this apparent contradiction is to say that the first stage of cognitive therapy is all about change.

We identify specific problems in the client's life and come up with goals embodying the ways that person's life would be different if we solved those problems – this is all about change.

We then identify the thoughts, beliefs and behaviours that are maintaining the person's problems and start to modify those – again, our agenda here is change.

But more advanced cognitive therapy places far more emphasis on acceptance than change. Increasingly, the new 'third wave' forms of cognitive therapy like schema therapy, compassion-focused therapy (CFT), dialectical behaviour therapy (DBT) or acceptance and commitment therapy (ACT) are a fusion of mindfulness, cognitive therapy and other approaches, such as experiential or psychodynamic therapies, to help treat more longstanding or hard-to-reach problems and conditions.

Mindful acceptance

Acceptance is at the core of mindfulness theory and practice, because the Buddhists who originally harnessed the power of mindfulness understood that in life there are many things we can neither change nor control. We all get older and eventually die, as do those we love and care for. We all suffer from problems with our health, especially as we get older.

Many things appear entirely beyond our personal control, such as climate change, the fluctuating economy, wars, natural disasters and even the actions of our own Government. So it is fruitless for us to spend hours worrying or disturbing ourselves about the things we cannot change – the Buddha discovered 2,500 years ago that an accepting mindset will greatly reduce our distress and unhappiness.

And we often find that, counterintuitively, mindfully accepting aversive or unpleasant feelings such as anxiety or anger and 'breathing into' them, rather than struggling, fighting or resisting them, helps those feelings naturally decrease and even dissolve. Acceptance can be both a powerful and empowering approach to solving some of our most painful problems.

In summary, change what you can and accept what you can't – not easy, by any means, but a very helpful way to live if you can manage it.

Warm wishes,

Dan

 

Is Someone Close to You Narcissistic?

Image by Obi Onyeador

Image by Obi Onyeador

Psychologists talk about 'personality types' when they are describing ways of thinking and behaving that are common to us all, such as being a bit selfish/self-focused, obsessive about tidiness, or consistently avoiding things we feel uncomfortable with. We are all on a spectrum with these traits, but for some of us they are much more pronounced than others.

You may also have heard the term 'personality disorder', which is when someone strongly exhibits characteristics of one or more of these types, to such an extent that it affects their whole personality (not just their mood, as in a 'mood disorder' like depression) and typically makes life very difficult for themselves and the people around them.

Another term commonly used (and often misused) in the media is 'narcissistic'. Correctly used, narcissism describes someone who tends to be extremely self-focused, viewing the world and the people they encounter as being there to serve their needs. They will probably have an Entitlement schema and so feel entitled to special treatment, attention and recognition of their unique skills, knowledge or personal qualities.

Narcissistic people also have a black-and-white view of the world and how things should be, with a strong belief that they are always right and that bad things in their life are other people's fault, not theirs.

Not every narcissist is willing to change, but some will – with enough leverage, incentive and assistance.
— Wendy Behary

Again, it's important to remember that we all have some of these traits and beliefs – it's how strongly those beliefs are held that's key. When these beliefs are deeply and rigidly held, then someone might be diagnosed with narcissistic personality disorder (NPD). Because people diagnosed with NPD tend to be extremely single-minded about getting what they want, we see these individuals at the top of a number of professions, such as banking, politics, law, professional sports, music and acting.

It's tough to be in a relationship with a narcissistic person, because they tend to be very perfectionistic and critical. Because empathy is not their strong suit, they just don't get why or how they have hurt someone, and will tend to fly into a rage when challenged or criticised. If any of this sounds like someone close to you, they may need help in learning to relate to others in a more compassionate, less self-serving way.

Schema therapy can help with that, if they can be persuaded to come along, which is often challenging. People with these characteristics usually end up in therapy because people – an angry boss or partner on the verge of leaving – have pressurised them to do so.

The most important thing is to understand why they are acting in baffling and sometimes hurtful ways – and remember that it's definitely not your fault. Knowledge is power, so read up on narcissism (I strongly recommend Disarming the Narcissist: Surviving and Thriving with the Self-absorbed, by Wendy Behary, a leading schema therapist specialising in narcissism) and develop strategies for protecting yourself and maintaining healthy boundaries.

Warm wishes,

Dan

 

Is Schema Therapy the Right Approach for You?

Image by Norbert Kundrak

Schema therapy is a form of cognitive therapy that was developed by psychologist Dr Jeffrey Young in the 1990s. Unlike cognitive behaviour therapy (CBT), schema therapy is a longer-term, more intensive treatment designed for people with longstanding, hard-to-treat problems such as recurrent patterns of depression, long-term OCD or other anxiety disorders, problems with intimate relationships and difficulties linked to painful experiences in childhood or adolescence. 

Schema therapy is a warm, compassionate form of therapy that emphasises the relationship between therapist and client as an important part of the healing process. Clients are encouraged to stay in touch between sessions, especially if they are struggling, which can be very helpful when times are tough.

In therapy we first identify which schemas a person has and how they developed in childhood (for example, someone may have an Abandonment schema, because one of their parents left the family or was emotionally unavailable for them).

We also identify your modes – distinct sides of you that become active at different times. For example, you may have a critical mode, which is the part of you that criticises and attacks for you for perceived failings or mistakes. Clearly, this is not very helpful, so we work together on transforming this mode to become an advisor rather than a critic.

And your Vulnerable Child mode is the part that feels vulnerable, lonely, anxious or threatened – this part needs nurturing, healing and protecting, which is a central part of the work in schema therapy.

CBT or schema therapy?

I would say that for most psychological problems, such as chronic stress, anger management, phobias, health anxiety, one-off episodes of depression, social anxiety, and so on, CBT is the most effective therapy for you. Having been a CBT therapist for many years, I am passionate about this practical, problem-solving, highly effective approach. It works really well for most problems, most of the time.

But I decided to train in schema therapy to help the people for whom CBT did not seem to be enough. Some of my clients just did not respond to CBT at all; others responded well for a while, then we seemed to hit a wall. Especially for problems related to childhood trauma, abuse or neglect, 'treatment-resistant' depression or anxiety disorders, or across-the-board problems affecting every area of someone's life, CBT techniques just did not work as well as I or my clients hoped.

Dr Young created schema therapy for people with exactly these kinds of problems. Because schema therapy involves working at a much deeper, more emotionally-focused level than with CBT, we can heal those past hurts that are causing you problems today.

Using experiential techniques like imagery and chair work, we can help you release and process stuck or painful emotions, while shifting unhelpful ways of thinking and behaving that make day-to-day life a struggle.

Schema therapy is a highly effective, potentially transformative approach – and may well help even if you have tried CBT or other therapies before, with little success.

Warm wishes,

Dan

 

What is Cognitive Therapy?

Image by Toa Heftiba

Image by Toa Heftiba

I offer cognitive and schema therapy at my private practice in East Finchley, North London and via Zoom – but what exactly is cognitive therapy and how does it differ from other approaches? Having trained in different schools of counselling and psychotherapy (including humanistic, integrative and cognitive therapies), in my work with clients I draw from the best of each.

All the major schools of thought are full of wisdom and have a great deal to offer but – for the vast majority of psychological problems, including stress, anxiety, depression, problems with anger, assertiveness and low self-esteem – it seems clear from all the evidence that cognitive therapy is the most effective approach.

Having helped many people with their problems, I also know from personal experience that cognitive therapy is an excellent way to help people feel better as quickly as possible. And when you're unhappy or unwell, that's clearly very important. Cognitive therapy works well as a short-term approach – typically 10 to 20 sessions – and schema therapy is extremely effective longer-term work, from 25 sessions to a year or more.

Schema therapy is designed to help people with longstanding or hard-to-treat problems. It will be helpful if you have tried other approaches but nothing has worked; or your problems are very wide-ranging, affecting your work, relationships or family life.

How cognitive therapy works

The central idea in cognitive therapy is that our unhelpful thoughts and beliefs strongly influence the way we feel and behave. For example, when you are depressed you may think very negatively about yourself and your life. You may also feel guilty or hopeless, and be consumed with regrets as you look back at what hasn't worked in your life.

This type of thinking, which is called 'rumination', is not helpful because it brings your mood down and rarely leads to effective solutions. So one of the first tasks in cognitive therapy for depression (or any other problem) is to identify these 'negative automatic thoughts' so you can begin to seek more constructive and realistic ways of thinking.

The great thing about cognitive therapy is that it's based on common-sense ideas and is designed to be a 'DIY therapy'. So I will teach you how to use these techniques yourself, between sessions and whenever you feel stressed, anxious, down or otherwise unhappy. You can then become your own cognitive therapist, able to withstand the stressful or challenging periods we all must face throughout life.   

So is cognitive therapy purely a short-term approach?

No, this is a common misconception. Cognitive behaviour therapy (CBT) is a highly effective short-term approach – many problems can be significantly improved with a course of therapy lasting between 10 and 20 sessions. But it's worth noting that cognitive therapy was originally designed by Aaron Beck as a 20-session treatment for depression; and for more long-lasting issues a longer-term approach is necessary, which will take as long as you need.

For example, if you have low self-esteem, you may well have struggled with deep feelings of insecurity or a lack of confidence for decades. So it's very difficult to change the way you feel about yourself in a few weeks or even months. It's better to be patient, helping you feel better in the short term before tackling the deeper-level beliefs that fuel low self-esteem.

This means looking at the deeper issues that led you to become unhappy, which almost always points to difficult experiences in childhood or adolescence. I will then help you understand why these early difficulties still cause problems in your work, family and romantic relationships. This will help you heal childhood wounds and become happier, stronger and better able to enjoy those relationships and your day-to-day life.

Isn't CBT just about filling in lots of forms?

Another common misunderstanding. Although it is very useful to record your feelings, thoughts and behaviour so you can begin to spot patterns and make some changes, cognitive therapists value warmth, authenticity and a strong therapeutic relationship as much as other practitioners.

In fact, in my opinion, the relationship between therapist and client is always the most important ingredient of any successful therapy. Making you feel safe, respected and valued is of great importance to me – any techniques must always come second to that.

Some people find it very helpful to write down their thoughts; others less so. So any good cognitive therapist will be flexible and find the approach that best suits the person in front of them. It's also important to remember that cognitive therapy is a collaborative approach.

This means that we will work as a team, first figuring out what caused your problems in the first place and then which factors might be maintaining it. We will then agree on the best ways to solve those problems in each session and over the course of your therapy.

Of course, I am happy to explain more about how CBT works when we meet. You might also want to read up on CBT – if so, I recommend the Overcoming... series of books, which focus on different problems. So for depression, read Overcoming Depression: A Self-Help Guide Using Cognitive Behavioural Techniques, by Paul Gilbert; for anxiety, try Overcoming Anxiety... by Helen Kennerley; for self-esteem problems, read Overcoming Low Self-Esteem... by Melanie Fennell.

Warm wishes,

Dan