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April 14, 2025 by BHP Leave a Comment

How can I manage my emotions better?

This is a common question clients ask therapists.

Sometimes clients describe having mood swings, one minute they are feeling fine and the next are feeling very low, and for others it can be suddenly feeling irritable or angry. Sometimes there is an obvious trigger to the change in mood but often clients report no trigger, just a general feeling of their mood having changed.

Understandably this can feel frustrating as well as being difficult for those around them – clients often say that their mood swings impact on their relationships.

In therapy we might start by looking at the bigger picture. We might ask the client if this is something they have always experienced or is relatively new. It could be that there has been a build-up of stressors or that the client’s work-life balance has become unbalanced, and so as stress has increased it has become more difficult to manage their moods. Often stress can creep up on us. We have an expectation that we can maintain a permanent level of ‘doing’ however this isn’t true. Often people think because they used to do all these things they should be able to keep on doing all these things. We can often compare ourselves to how we used to be and hold an expectation that we should be able to keep going. However, stress can accumulate and over time this can become more difficult to manage. The analogy of the stress bucket is useful here. If you imagine the size of the bucket represents a person’s stress tolerance and this is influenced by personality, genetics, upbringing and experience. The bucket fills up with stressors from home, work, family, finances, illnesses etc. When the bucket is full up it can lead to problems such as low mood, anxiety, fatigue, headaches, sleep disturbance and overwhelm. We need strategies to stop the bucket overflowing.

This is where therapy can help. Together we can explore stress management strategies and talk through the stressors. Often difficult experiences build up and we don’t allow ourselves time to properly process them.

For others it could be that they have always found it difficult to manage their emotions. This could be because they’ve never really learnt to manage difficult emotions and so they struggle with tolerating them. Sometimes unhealthy ways to manage develop such as drinking too much alcohol, comfort eating, sleeping or taking drugs. These are different ways to avoid feeling difficult emotions. However, these only work in the short term, can be difficult to give up and can lead to mental health difficulties such as depression, anxiety and low self-esteem.

Cognitive behavioural therapy (CBT) is an effective treatment in managing emotions. It looks at the interaction between our thoughts, moods, physical symptoms and behaviours. It can be useful to use the basic CBT model to start to breakdown what’s going on when you first notice the shift in emotion/mood. When you first notice that shift in your mood ask yourself what was going through my mind at the time, what were the words my mind was saying (i.e. your internal dialogue); name the moods/emotions that you were feeling at the time (there can be more than one mood); how were you feeling inside of your body, what were the physical sensations; and what is it you were doing or not doing (behaviours). Also try to identify the trigger, what were you reacting to? Was it an event or situation or was it that you started to think about something, and this triggered a shift in your mood. By breaking down your experience in this way we can really look at what is going on. We can start to identify early signs and symptoms that happen when your mood changes. We can look at what might be unhelpful in the way you are thinking that could inadvertently be maintaining the cycle. We can see what you are doing or not doing that also might be contributing to maintaining the cycle.

It can help to write these answers down. The process of recording can help to give us clarity and can be a strategy in its own right. Once we have gathered this information and identified what’s unhelpful, we can start to look at ways to make changes, what might be more helpful.

Noticing your emotions and naming your feelings can be useful, but it’s not always easy to do this if it’s something you’re not used to doing. When we notice physical sensations happening in our body, we can think about why these might be happening. Was it that you were thinking of something that’s happened in the past or worrying about something in the future? Or was it that you were feeling a certain way and started to give a meaning to what you were feeling? How we are thinking impacts on how we feel emotionally and physically. Just as how we are feeling in our mood and in our body will impact on how we think.

When managing our emotions it’s important to be kind to ourselves: to think self compassionately; to treat ourselves how we would treat others; to forgive ourselves when we make mistakes; and not give ourselves a hard time when we don’t achieve everything we would’ve liked to. Be mindful of the way we talk to ourselves. We need to accept our different emotions rather than trying to fight them. It’s okay to feel ‘negative’ emotions, it’s part of being human. Telling ourselves we shouldn’t feel like this, judging ourselves harshly or criticising ourselves doesn’t help. Just as trying to avoid or dismiss the emotion doesn’t help. We need to learn how to self-soothe and reach out to others for support.

CBT helps us learn how to recognise unhelpful thoughts and challenge them, and to identify unhelpful behaviours. If we can make changes in these areas this will have a direct impact on our emotions.

We can all experience difficult emotions at times, it’s normal, just as we can all need a little help in how we manage them.

 

Brighton and Hove Psychotherapy is a collective of experienced psychotherapists, psychologists and counsellors working with a range of client groups, including fellow therapists and health professionals. If you would like more information, or an informal discussion please get in touch. Online therapy is available.

 

Filed Under: Mental health, Psychotherapy Tagged With: CBT Therapy, Cognitive, Emotions

April 15, 2024 by BHP Leave a Comment

The empty chair in therapy

Can talking to an empty chair help ease our mental distress and help make us more positive and confident?

It may seem a strange idea, but evidence has been accumulating for more than ninety years that it can. The techniques involved, initially called ‘psychodrama’, originated in 1930s New York. They were refined in the 1950s by a pioneering psychoanalyst called Fritz Perls – the father of Gestalt therapy – and now form an important part of the ‘toolbox’ used in a range of therapies.

Chair work involves the use of physical or imaginary chairs to facilitate dialogue between different aspects of the self, or to explore conflicting emotions, thoughts, or perspectives.

Such work is at the heart of cognitive behavioural therapy (CBT) and schema therapy, which I have practised for almost a decade. It is designed to allow you to push away or reduce the impact of criticisms and deficiencies of care you have received from others from your childhood onwards, and to stop your own inner critic – usually rooted in shame – from hobbling your self-confidence and self-esteem.

The core premise of the technique is that talking in the present, in the safety of the therapy room and under the guidance of the therapist, to those who caused us problems in the past, helps to take the ‘sting’ out of negative memories stuck in the fight-flight area of our brains and to feel that we are back in control. Put another way, this is a route towards being able to regulate our negative emotions such as fear and anger more effectively.

Equally, talking to voices coming from within – for example our self-critical mode, or our ‘vulnerable child’ mode, both of which can be very debilitating if we have had insufficient care during our childhoods – can help us to boost our sense of agency and ability to self- soothe and self-validate.

What are the practicalities of chair work? To explain, I have created the example of John, an imaginary client now in his early thirties with problems typical of those which frequently surface in the therapy room.

As John grew up a key element was that his father – who was irascible and a big drinker – was very hard on him about doing homework and frequently yelled at him that he must do better. He regarded anything less than a grade A as failure – and failure led to consequences, from being grounded to pocket money being withheld and sometimes, beatings. Young John found such treatment very difficult to cope with because his
understanding of the world and his powers of reasoning were not fully developed. The father who was supposed to love him was a vengeful aggressor. It was cruel and frightening and his young self felt like there was no way of escape or answering back.

The impact went much deeper. John was traumatised by some of the more extreme punishments. He also came to believe that the pressure from his father was his fault because he simply wasn’t good enough. He was ashamed of himself and felt continually vulnerable because he was convinced that whatever he did was sub-standard.

When he started work, receiving criticism of any kind made him feel very insecure and often triggered him to defensive anger against his perceived attackers. At other times, he avoided exposing himself to the possibility of the type of behaviour his father had so often displayed by being insular. John was very bright but progress in his career was hampered by his very deep-seated negative beliefs about himself and the world – all rooted in his father’s mistreatment.

To help tackle these problems, I first went through with John the history of his relationship with his father and explained how such punitive and demanding behaviour undermined his self-esteem and of having a secure base in his life. Then came the chair work. The goal was to bring into the room the possibility of re-engineering what happened to him as a child, this time with him – rather than his father – calling the shots.

I asked John first to imagine how in his grown-up life, what he would want to say to someone who was treating a child like his father treated him. John was quick to say that he would tell him that such bullying was not acceptable and unfair to a child.

I then brought an empty chair at right angles to us both in the space between us. I asked John if he minded imagining his father as he was in his childhood sitting in the empty chair.

He was reluctant at first on the ground that it felt scary, even now. I reassured him that the difference between then and the present was that he was alone back then, and that I, as his therapist, was there to help and protect him.

I then asked John – as his grown-up, healthy self in the safety of the therapy room – what he would like to say to his father. His first reaction, exactly as when he was a child, was fear and reluctance. I reassured him again that he was safe, and eventually – at first slowly, but gradually gathering pace – he told his dad that he loved him but felt that what he had done to him regarding homework was very unfair, frightening and cruel. Gathering in confidence, he told him that it should never have happened and that he was still struggling with the consequences, that he had never felt good enough.

Much more happened on John’s therapy journey, but the chair work encounter with his father was a turning point in creating a new awareness of what had happened to him and in realising he had a choice in how he could control the distress he had so often felt. He had developed his own voice – and agency – in dealing with his father.

Reference works for further reading:

Cognitive Behavioural Chairwork, Matthew Pugh, Routledge, 2020.

Contextual Schema Therapy, Eckhard Roediger, Bruce Stevens and Robert Brockman,
Context Press, 2018.

 

David Keighley is a BACP Accredited counsellor/psychotherapist offering short and long term therapy to individuals and couples using a variety of techniques such as EMDR, CBT and Schema Therapy. He is also a trained clinical supervisor.  He is available at our Brighton & Hove Practice.

 

Further reading by David Keighley

How therapy can help with anger issues

Do you have unrelenting standards?

Why we need a ‘secure base’

Filed Under: David Keighley, Psychotherapy, Relationships Tagged With: Cognitive, Family, Relationships

February 15, 2021 by BHP Leave a Comment

Executive Function Skills (part 1) – What They Are And Why Some Children Struggle With Them.

Executive functions are the cognitive skills we use to control and regulate our thoughts, emotions and actions to achieve goals. These three main areas of executive function work together:

  • Self-control/ inhibition – the ability to resist doing something distracting/ tempting in order to do what’s needed to complete a given task, helping us to pay attention, act less impulsively and stay focused.
  • Working memory – the ability to hold information in mind and use it to make connections between ideas, make mental calculations and prioritize action.
  • Cognitive flexibility – the ability to think creatively, switch gears and be flexible to changing requests and situations, allowing us to use imagination and creativity to solve problems.

For example, all three areas are needed in social pretend play:

  • Child needs to hold their own role and those of others in mind (working memory)
  • Child needs to inhibit acting out of character (employ self-control), and
  • Child needs to flexibly adjust to twists and turns in the evolving plot (cognitive flexibility)

The joint forces of our executive function skills can be thought about as . . .

  • the conductor of an orchestra, organising multiple instruments to make one unified sound or
  • an air-traffic controller managing safe take-off and landing for hundreds of air-craft

Executive functions are controlled by the frontal lobes of the brain which are connected with and control the activities in many other regions of the brain.

Hot and Cool Executive Functions
Hot executive functions are the self-management skills we use in the heat of the moment when emotions run high – they require concerted conscious effort and help us give up short term gain for the sake of a more important goal. Examples include: resisting temptation; focusing on a boring task; breaking an old habit; and biting our lip when angry. Cool executive functions are the skills we use when emotions aren’t really a factor. Examples include: remembering a list of numbers and repeating them back in reverse order and following a simple recipe.

Executive function skills are a vital part of learning. They help children to be in the right place at the right time with the right equipment, listen to the teacher, wait for a turn and not call out. They are also pivotal in managing frustration, getting started on a task, staying focused, accepting constructive criticism and asking for appropriate help. They enable children to notice and correct mistakes, prioritise, persevere and complete challenging activities, resist the urge to retaliate and feel more confident about managing in school.

Children with under-developed executive function skills may act without thinking, overreact to small problems, be upset by changes in plans, forget to hand in homework, delay starting effortful tasks, switch between tasks without finishing any, lose or misplace things, struggle to meet deadlines and set goals, and lack insight into their behaviour.

Factors which can make it harder to access our executive function include tiredness and sleep deprivation, dyslexia and more complex learning difficulties, neuro-developmental conditions like Autism and ADHD, environments which overwhelm our senses and create stress, one-off traumatic incidents and complex trauma as a result of Adverse Childhood Experiences.

Given their significance, difficulties with Executive Function can contribute to social, emotional and mental health difficulties if they are unsupported and children who are already vulnerable for any of the above reasons may experience a compounding of the challenges they face. It is therefore essential that we take time to understand what these issues look like for each individual and adjust parenting, schooling and community interventions accordingly.

Look out for my forthcoming blog –  Executive Function Skills (Part 2) for ideas on how to support children with these difficulties.

 

Brighton and Hove Psychotherapy is a collective of experienced psychotherapists, psychologists and counsellors working with a range of client groups, including fellow therapists and health professionals. If you would like more information, or an informal discussion please get in touch with us. Online therapy is available.

 

Additional resources –

  • UNDERSTOOD website: https://www.understood.org/en/learning-thinking-differences/child-learning-disabilities/executive-functioning-issues/what-is-executive-function
  • The book  Why Can’t I Do That? A Book About Switches by Fi and Gail Newood is designed to help children understand what Executive Function skills are and how they link to everyday challenges.

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Filed Under: Child development, Families, Parenting Tagged With: child therapy, childhood developmental trauma, Cognitive

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