Rebecca Mead Blogs - Brighton and Hove Psychotherapy

April 19, 2021 by BHP Leave a Comment

As we come out of lockdown, will a number of us be feeling socially anxious?

For the past year we have largely been confined to our homes, a lot of us working from home and only going out for regular exercise. Our social lives have been depleted, we’ve not been able to see friends and family and generally life may have become quite repetitive.

As we come out of lockdown there will be mixed feelings, some people may feel really ready to socialise again and are already filling their calendars with get togethers and events. For others, they might be more cautious and be worried about feeling anxious in group settings.

Perhaps you’ve always found social gatherings difficult and so the lockdowns gave you permission to not have to socialise. By having to keep ourselves to ourselves anxiety has not been triggered or challenged and so confidence in social settings may have reduced. The prospect of now going into situations where there are more than two people may feel quite daunting.

Because we’ve not had much going on in our lives we may start to worry that we have nothing to talk about. Or perhaps our appearance has changed a little, we’ve put on some weight, or we’re not as toned as we were or our hair is more grey than it was, and so we are worried we will not look physically good enough. Or perhaps we are worried whether our friends will still want to see us after all this time.

These are normal thoughts that we may experience but they aren’t helpful and we may have to work at keeping them in check. It’s worth reminding ourselves that thoughts are not facts and whilst we may have these thoughts about ourselves it doesn’t mean that others are having these thoughts about us.

We’ve all been socially deprived over the last year and when you haven’t done something for a while it can feel uncomfortable going back into it, its normal to feel some level of anxiety. Just as the more we avoid something the harder it becomes to do. Be kind to yourself, don’t expect yourself to be able to go straight into large social gatherings. It’s better to return to socialising in a graded way. If it feels too big it’s ok to say you’re not ready.

When we are feeling socially anxious we can start to worry about how we come across to others and feel like we’re in the spotlight. The more we focus on ourselves the more self conscious we can become and the more this happens the more we end up in our own head. The more we start to judge ourselves and the more difficult it becomes to interact with others. We can’t be concentrating on what is going on around us or what others are saying if we’re so busy in our heads judging ourselves. Try shifting your focus onto others, paying attention to what’s being said rather than your internal dialogue. By shifting your focus of attention outwards to others, from internal to external, you can keep more relaxed.

A common fear to have when socially anxious is thinking you should be interesting all of the time. How realistic is this? particularly given that none of us have had very interesting lives recently. Take the pressure off yourself to perform, it’s about being with others, not entertaining others. Share how bored you’ve been, I’m sure others will have been to. Try to reduce those high expectations of yourself.

Another fear is to think that others can see your anxiety however the research tells us that this is not the case. What feels magnified and obvious to you, such as shaking or sweating, isn’t visible to others.

It is also unhelpful to prepare things to talk about as this again puts pressure on yourself to perform and maintains self focus. If you’re so busy thinking about the list of things you’ve prepared you’re not going with the flow of conversation, you become more self focused and can appear uninterested in what’s being said or aloof.

Lastly don’t allow yourself to replay or dwell on what you said or did later. No one else will be giving a second thought to what you’ve said or done, they will have moved onto the next thing in their day. You’re the only one analysing yourself and giving yourself a hard time.

Remember social interactions are a two way street, it’s not all your responsibility. The more we can focus on the social event rather than ourselves the more we are likely to enjoy the social interaction.

To enquire about psychotherapy sessions with Rebecca Mead, please contact her here, or to view our full clinical team, please click here.

Further reading by Rebecca Mead –

New Year’s Resolutions

Making Changes

February 1, 2021 by BHP Leave a Comment

New Year’s Resolutions

In my last blog I wrote about goals for change and linking these to our values. When someone decides to come into therapy it is often because they would like to make changes and it can help to set goals as a means of knowing when these changes have been achieved.

Given this is a time of year when we might have made New Year’s Resolutions it seems quite fitting to talk a little more about setting ourselves goals for change. It is often the case that at the start of the year we have all these wonderful ideas of what we want to achieve and we start off really motivated with all good intentions and then several months in we start to lose heart and give up.

A common goal at this time of year is dry January and this can quite often be successful because its time limited. We know that after a month we can return to our favourite tipple. However, for some this is difficult, particularly in the current situation with the stressors of Covid. Complete abstinence can be too challenging as its very all or nothing. It might be more helpful to consider cutting down and reducing frequency, e.g. limit to just one drink once or twice a week. In this way we can make the goal more achievable. Making our goals for change realistic and time limited is really important for achievement.

Another common goal for this time of year is to get fit and start exercising. To start with when we are motivated it goes well. It’s the trying to keep it up that’s difficult. Part of the battle is finding what exercise you enjoy. There’s no point pushing yourself to do something you don’t like. Often when people think of exercise they think they have to do something cardio related. However, there are lots of low impact workouts that are good forms of exercise, such as walking, yoga and pilates. Whatever choice you make its important to start small and build up. It’s the achievement that helps to maintain the motivation. So the first week or two you might aim to exercise for 20 minutes twice a week and then the third week, 3 times per week. Once you have comfortably achieved the first goal you set another, building on the first to push yourself that little bit further. All the time holding in mind where you want to be and this is where it can be useful to link goals to your values. In this example its values around physical well being and of course exercise is also great for our mental health.

Losing weight or eating healthier is another very common goal for people to set themselves at this time of year. And again is another that can be difficult to maintain. So rather than push yourself to go on a really restrictive diet or to cut out entire food groups consider aiming for a ‘better’ diet. Try reducing unhealthy food groups, reducing treats, and swapping to more healthy options. It can be more helpful to aim to eat healthily for 75% of the time or to eat healthily in the week and let yourself indulge a little at weekends. Again, it’s about trying to set more realistic goals for yourself. For example if your norm is to eat half a packet of biscuits with your cup of tea to allow yourself just 2 biscuits rather than going for complete abstinence.

Thinking about setting the right goals is really important and if you don’t achieve them, that’s o.k. There’s no such thing as a failed goal. If you don’t achieve your goal then there is still useful information – ask yourself why wasn’t I able to achieve this? What got in the way? What is the learning from this? What can I do differently next time? Are there any supports available to me to assist in this? Often we don’t achieve our goals because they are too big and need to be broken down further.

None of this is rocket science but we all to easily forget the basics. We can impose high expectations on ourselves and then become disheartened when we don’t achieve them. Our self critical voice kicks in and this can have a negative impact on our mood. Given the difficulties we are all facing currently its even more important to be kind to ourselves and realistic of what we can and can’t achieve.

To enquire about psychotherapy sessions with Rebecca Mead, please contact her here, or to view our full clinical team, please click here.

Further reading by Rebecca Mead –

Making Changes

Face to Face and Online Therapy Help Available Now

December 7, 2020 by BHP Leave a Comment

Making Changes

As well as working privately, I work within an NHS IAPT Service providing psychological therapy for depression and anxiety disorders and when a client comes into therapy, one of the first things we discuss is goals for treatment.

What is it the client is hoping to change by the end of treatment? Is there anything that the client is not able do now, because of their difficulties, that they would like to be doing in the next couple of months?

Goals help to focus the therapy. It’s quite common that the client will say they would like to increase their confidence or to improve their self esteem, to be less anxious or to be happy. These are very broad goals, would be difficult to measure and don’t tell us what the client would actually be doing differently if they were to be confident, have better self esteem, be less anxious or be happier. So we work together to work out what this might look like.

One way to help determine goals for change is to think of our values. When considering values we need to think about what is really important to us, what gives our life meaning and purpose. Values are what we care about and are different for everybody. They can change over time depending on where we are in our life. Meaningful activity is value driven. Values are fluid and don’t have an end point, they are how we want to live our lives, they help us to be the person we want to be.

We hold values in different areas of our life: intimate relationships / marriage / being a couple; family relations; friendships & social relationships; parenting; career / employment; physical wellbeing / healthy living; connecting with the community; spirituality; education / training / personal growth; mental wellbeing.

It can be useful to consider what values you hold in each of these areas and rate how important each domain is to you and where you are in achieving that domain. For example what kind of values do you hold in physical wellbeing? How do you want to look after yourself physically? Is it to take regular exercise, eat healthily, get enough sleep and rest? Are you achieving this as much as you would like to be? What sort of friend do you want to be and how would you like to act towards your friends? For example, loyal, trustworthy, to spend time with friends, to share, to listen, to have fun together. What kind of values might you want to model as a parent? For example, to be curios, have courage, be adventurous, have determination, gratitude kindness and have fun (to name but a few). Values can be described as compass directions in which we live our life.

If you feel that you are not where you would like to be within a particular domain, how can you bring this value further into your life? This is where goal setting comes in. Values are a direction we want to progress in. Goals can be set to help us achieve that direction. For example, if we place value upon exercise and physical health we might have the goal of going for a swim twice a week or we might have a goal of completing a qualification, which sits within the value of education and personal growth. Goals can be achieved and have an end point. You maybe familiar with the acronym SMART goals. This means goals are specific, measurable, achievable, realistic and time limited. So if we wanted to make the goal of ‘going for a swim twice a week’ into a really SMART goal we could add a set time period, i.e. ‘going for a swim twice a week for half an hour’. By setting SMART goals we break down the areas of change into manageable chunks.

Change is difficult and if we are feeling low or stressed and anxious we can often feel overwhelmed. It is likely that areas of our life that are important to us have become affected and we don’t know where to start to change this.

Setting ourselves small goals for change in line with our values is a useful starting place. It’s important to remember that there is no such thing as a failed goal. If we don’t achieve our goal it still give us useful information. Perhaps we set ourselves an unrealistic goal, in which case we might consider how we can break this down further into smaller, more manageable chunks. We can explore the process along the way whilst trying to achieve our goals and moving towards our values. In this way change takes place and has a positive impact on our mental wellbeing.

To enquire about psychotherapy sessions with Rebecca Mead, please contact her here, or to view our full clinical team, please click here.

Further reading by Rebecca Mead –

Face to Face and Online Therapy Help Available Now

November 9, 2020 by BHP Leave a Comment

Social Connections

“Social connection can lower anxiety and depression, help us regulate our emotions, lead to higher self-esteem and empathy, and actually improve our immune systems. By neglecting our need to connect, we put our health at risk.”
JS House, KR Landis, D Umberson (2019)

Social connection can be difficult to do right now as we find ourselves amidst the Covid-19 Pandemic. We have been told we must socially distance, limit our social connection with others to no more than 6 people at any one time and stay in our established support bubbles. We are now told that we are at risk of a ‘second wave’ and socially connecting can seem even more frightening and confusing.

As we continue to live amidst global uncertainty, we may have found our social connections inadvertently diminishing.

So how do we stay socially connected to maintain our mental wellbeing?

Rather than discussing the various means which we are now using to stay connected, such as Zoom, Facebook, What’s App, etc, I would like to explore how we might identify the people in our lives that can help support us through these difficult times. It is very easy to get caught up in our daily lives, trying to get a balance between work, children, school, hobbies, self-care and more. All too easy our social connections fall by the way side and this can have a detrimental impact to our wellbeing.

I would like to draw upon the Interpersonal Psychotherapy (IPT) approach to help explore this. IPT is based on the premise that there is a relationship between the way people interact with others and their psychological symptoms. The focus of IPT is to improve the quality of a person’s interpersonal relationships and social functioning to help reduce distress. Part of the process in doing this is to identify a person’s interpersonal inventory. This is an exploration of the relationships in a person’s life and identifying ways in which these relationships can contribute to a person’s recovery from emotional distress.

What can be useful in the first instance is to consider all your relationships in your life, in particular those that make you feel better. It’s important to remember no relationship is perfect and no one person can meet all your needs so try to be as inclusive as possible. It is also helpful to consider what support is available to you? When we consider support it is not just emotional support that is important, it can also be social, motivational, practical, educational and even financial. Finally, how available are these relationships to you? This doesn’t have to physically be in person. Not everyone is available all of the time and it can be helpful to identify when different people are likely to be available, e.g. in the evenings or at weekends.

Identifying all the people in your life enables you to have an overview of your relationship world – the overall itself might tell you something important, e.g. that you have few people in your life but they are all very close to you and provide a lot of support.

You can draw a diagram of all the people in your life using concentric circles this allows you to show how close you feel to each person (don’t forget to write yourself in the middle). The most immediate circle to yourself would include those that you are closest to – this would typically be the people that you spend most time with and that are emotionally involved with. Just because these are your closest relationships doesn’t mean they are perfect but they are likely to be your most significant.

Try to ensure that you include everyone, i.e. those that you see in your daily lives, family, children, friends, work colleagues, neighbours, those that you don’t see very often but still regard as friends, those that you may share interests or hobbies with, children’s school friend’s parents, your extended family, even pets.

This exercise enables you to identify who is in your life and how close you feel to them, to consider the support those in your life provide and to consider how available they are or when they would be available.

By having a visual reminder of who we have in our lives we can begin to work at reaching out to our social network – Who haven’t we been in contact with for a while? Who can we pick up the phone to or go for a walk with? Who can we arrange a Zoom meet up with or create a What’s App chat with? We might need to set ourselves weekly goals to pick up that phone or send a message to stay connected, or to reach out for support in these difficult times. Just having a chat with someone can have a positive impact on how we are feeling or being in someone else’s company.

It’s important to remember we are not alone and by reaching out to others for support we will also be helping others to feel more connected and supported. Staying connected is fundamental in maintaining our mental wellbeing now more than ever.

(Reference: Chapter 9, Your Interpersonal Inventory – Rosalyn Law, Defeating Depression.)

Further reading by Rebecca Mead –

Face to Face and Online Therapy Help Available Now

April 6, 2020 by Brighton & Hove Psychotherapy Leave a Comment

Back to ‘BACE’ics

Work life balance is fundamental to our mental wellbeing and can easily become out of sync without us even realising it, particularly when we are feeling stressed. This imbalance can lead to depression and anxiety. Going back to basics and keeping an activity diary for a week or two can provide us with useful information. Broadly speaking we are interested in 4 different areas:

1/ Bodily Self Care – this would include how we look after our physical body, i.e. exercise, nutrition, rest and sleep, self-grooming, medication, etc.

2/ Achievement – this would include work, study, housework, any tasks / activities that gives us a sense of having achieved something.

3/ Connecting with others – this can be family, friends, work colleagues – in person, over the telephone or social media. It can simply be being in an environment where there are others as long as we feel connected. It can also include connecting with animals. Our pets can be very therapeutic.

4/ Enjoyment – hobbies, interests, fun activities, relaxing activities – anything that gives us a sense of pleasure

Each day categorise how you are spending your time into each of the areas. Sometimes one activity may fulfil more than one category, e.g. walking the dog can be exercise so would meet bodily self care, it could also be an achievement if you really didn’t feel like going, it could be connecting with others as you may have met other dog walkers, and you may have enjoyed it.

By monitoring our activity according to these categories we can gather information and gain a sense of where there are gaps, where we might need to make some changes in our lives.

In my work as a CBT therapist I see all too easily how we can forget to enjoy ourselves. We can get so caught up with work and what we think we should be doing we can lose sight of enjoyment and connecting with others. Or we may have crammed so much into our day that we have no time to stop and just be. Activity monitoring can be a useful tool for anyone who wants to take stock and see whether they are tending to their mental wellbeing. To help us do this we can use a form called BACE (https://www.get.gg/docs/BACEdiary-weekly.pdf) which is a daily activity monitoring form. You will notice that the word BACE is an acronym for the four areas.

Once we have gathered information and highlighted the areas that need to be addressed we can use the same form as a daily planner to set ourselves small goals to address the gaps.

Sometimes the simplest strategies are the most helpful.

Further reading by Rebecca Mead –

Face to Face and Online Therapy Help Available Now

December 16, 2019 by Brighton & Hove Psychotherapy Leave a Comment

Interpersonal Therapy (IPT) Explained

When we are feeling depressed it is common to withdraw from those that we are close to, to shut ourselves away, turn down social invitations and generally pull away from friends and family. By doing this we are refusing the help and support of others, possibly because we feel bad about ourselves or that we have failed in some way, or that we will burden others. Friends and family may feel hurt and rejected by our withdrawal, they may not understand and feel that they are being shut out consequently may start to pull away from us. We may then interpret this behaviour as confirmation of our view of ourselves as ‘a burden’ or ‘a failure’ consequently perpetuating, and even increasing, our symptoms of depression. Thus a vicious cycle is inadvertently created.

This example illustrates the fundamental concept of IPT – that depression can be understood as a response to current difficulties in relationships and in turn depression can affect our relationships. If a focus on your current relationships makes sense to you then IPT could be the therapy approach for you.

IPT is time limited, usually between 12 and 16 sessions, its structured and is recommended in the NICE Guidelines (National Institute for Health and Care Excellence). NICE is like the NHS Bible and recommended treatments are well researched and evidence based.

The main focus of treatment is on relationship difficulties and on helping you to identify how you are feeling and behaving in your relationships. IPT typically focuses on the following relationship problems:

Conflict within relationships – this can often be difficulties within a significant relationship where the relationship has become ‘stuck’ in arguments or disagreements and has become a cause of stress and is having a significant impact on mood.
Change in circumstances such as redundancy, breakup of relationship or other life event that has affected how you feel about yourself. This can include happy changes such as becoming a parent or moving. However significant change can be difficult to adjust to and have an impact on how we feel about ourselves and others.
Bereavement – it is natural to grieve for the loss of a loved one however sometimes we don’t seem to be healing from the loss. We can continue to struggle to adjust to life without that loved person.
Isolation – Difficulties in forming and maintaining relationships – this can be due to not feeling close to others or not having many people around. Not having company or support of others can be stressful and leave us feeling very alone.

During the first few sessions of therapy we will gather information about your difficulty, create a time line of your symptoms and discuss current and past relationships in your life. Once we have gained a good understanding of the problem and the connected relationship difficulties we will collaboratively agree on which of the 4 areas therapy will focus on.

The benefits that IPT can bring include: Improvement in relationships, including relating to others and communication, learning to cope with emotions and life changes, problem solving, processing loss and grief, and overall an improvement in mood and psychological distress.

Face to Face and Online Therapy Help Available Now