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May 4, 2020 by Brighton and Hove Psychotherapy Leave a Comment

Why am I feeling more anxiety with Covid-19?

During the last 100 days, all of our lives, across the globe, have been turned upside down. Whilst scientifically overdue and rationally unsurprising, the pandemic has shaken the foundations of our outer, and thus, inner worlds. What we came to see as normal has been curtailed or removed; what we relied on for our own sense of normality has been fractured. 

Is everybody feeling more anxious? 

No, but that does not make those who are wrong or ill. Some people are feeling less anxious as their ‘ordinary’ level of anxiety (which may be quite high) now have an outlet – something tangible to attach to. Think of the example of a soldier who is able to thinking function efficiently in a war zone but who, upon returning home to an ‘ordinary’ environment, struggles to function as they locate threat behind every corner. 

There are also some who have a healthy relationship with their ‘anxious’ selves and are able to recognise the source of their anxiety and to use it whilst holding onto a thinking mind – such folks may feel a broader and deeper range of all their emotions at present but would not describe themselves as ‘more anxious’. This is possible for us all. 

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We are all going to die! 

It is a fact – no way round it – we are all going to die. Though probably not from Covid-19. In fact the likelihood of death from Covid-19 is statistically very low. 

I am not interested in getting into the actual mortality rates etc. for Covid as they have little to do with the anxiety I am addressing – suffice to say that Covid is real and each death is a personal tragedy – like deaths always are. 

However, there is more than meets the eye in the sub-heading of this section of my blog which may shed some light on heightened anxiety levels which I shall attempt to explain. 

Let’s start with the premise that human beings, generally, have a strong biological drive to live – like all other mammals. 

Back to Freud 

Freud posited that the majority of our decision making and therefore emotional work remained largely unconscious to us. He was right about this as has been evidenced in neuroscience experiments. 

Freud also suggested that we have a profoundly unconscious fear of death linked to our consciousness of self – we know that we are alive and therefore we also know we must die and this presents a dilemma. 

All anxiety is death anxiety 

Anxiety is not like the other emotions. It is free floating and pervasive. We all must live with anxiety whether it dominates our experience or is just a flicker on the horizon. 

All other emotions are ‘attached’ to something in that we generally know or can work out why we feel a certain way. We generally know what we feel happy or sad for example – and if we don’t the psychotherapy can uncover the reasons. 

Anxiety is different in the sense that it ‘seeks to attach’ to something. So, rather than being anxious about a presentation, a flight, an exam or a date, our anxiety ‘finds’ something in our environment and then attaches to that convincing us that that thing is what is causing our anxiety. 

Of course real things cause anxiety, however, on a profound (ontological) level, all anxiety stems from an unconscious but ubiquitous knowledge that we are going to die. It is therefore death anxiety. 

Covid represents the perfect vehicle to which our anxiety can attach – it kills. Just not very many of us. It is not a Hollywood movie like Independence Day where the enemy will destroy us all unless we mount a global war (and towards an enemy that we can see – and is monster-like). Covid is invisible to us but nonetheless has triggered a profound death anxiety in all of us – we are primed to feel anxious in the face of death as though we are hard-wired. 

What can I do? 

Earlier I mentioned the term ‘a thinking mind’ and this is one I have written about before. Even though are all primed to feel more anxious when reminded of death (check our Terror Management Theory for empirical evidence of this), it does not mean we need to lose our rational minds and succumb to the anxiety and the accompanying acting out. 

Your mind is capable of thinking and scanning for evidence. For example, if you are reading this piece right now, stop breathe and look around you. Look out of a window and notice that in this precise moment, you are not dying. You can use your sense to ground you: 

  • What can I see; 
  • What can I hear; 
  • What can I smell; 
  • What can a taste; 
  • What can I seen – my breath, my heartbeat, tension in my body etc. 

I must buy toilet paper! 

Much has been made of the compulsive need to purchase toilet paper as the pandemic emerged and took hold. And this seem to be a global rather than local phenomenon (though Americans seem to have a compulsive need to purchase firearms – but that adds confirmation to the theory below). 

So why toilet paper? Well, when anxious humans would rather do something rather than just sit there – and what we often need to do is stop and just sit there. Particularly when we are not about to immediately die. 

Toilet paper is intricately linked to a biological need that we would prefer didn’t exist. The need to defecate. The need to defecate links us to nature and to being, at least in a significant part, animal. Being linked to nature and thus being an animal means that we are mortal – something that is unconsciously unbearable for the part of us that is ‘God-like’ and able to project ourselves back into the past or forward into the future. In short, toilet paper became a manic defense against death but ensuring that we had the ability in the face of death to ‘wipe away’ any evidence of our animal nature. 

Briefly returning to the questions of guns and our American friends – I posit that guns are the way Americans take responsibility for avoiding death anxiety – by protecting themselves against the enemy. Perhaps thank Hollywood for this (even though Covid-19 cannot be shot). Oh, and I am fairly sure they also stocked up on toilet paper.

 

Mark Vahrmeyer, UKCP Registered, BHP Co-founder is an integrative psychotherapist with a wide range of clinical experience from both the public and private sectors. He currently sees both individuals and couples, primarily for ongoing psychotherapy.  Mark is available at the Lewes and Brighton & Hove Practices.

 

Further reading by Mark Vahrmeyer –

Why psychotherapy sessions should end on time

Coronavirus Induced Mental Health Issues

Coronavirus (Covid-19) Counselling

How being ordinary is increasingly extraordinary – On the role of narcissistic defences

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Filed Under: Mark Vahrmeyer, Sleep Tagged With: anxiety, self-awareness, wellbeing

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

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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.

 

Rebecca Mead is an accredited, registered and experienced Psychotherapist offering Cognitive Behavioural Therapy (CBT) and Interpersonal Psychotherapy (IPT) to individuals adults.  Rebecca is available at our Brighton and Hove Practice.

 

Further reading by Rebecca Mead –

Interpersonal Therapy (IPT) explained

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Filed Under: Rebecca Mead, Sleep Tagged With: self-care, self-worth, wellbeing

March 23, 2020 by Brighton & Hove Psychotherapy Leave a Comment

Spirituality and Mental Health

Spirituality is an often-used term these days, and around 20% of the population in the UK define themselves as spiritual, but not in the religious sense. So what does it mean to be spiritual?

There are many definitions of spirituality but generally we could say that it involves having a sense of something bigger than ourselves – a transcendental view of life where we start to realise that there is more to life that we see around us. This can include a sense that there is a God or creator, an intelligence in the universe, or maybe a deeper wisdom that we all carry. However we conceptualise it, spirituality often leads to a greater sense of purpose and meaning as we start to step back from the everyday world and see a bigger picture playing out before us. Spirituality also includes a sense of connectedness, which might be with others, ourselves or with something more transcendental. This feeling of connectedness can bring us a great deal of peace as we start to realise that perhaps we are not alone in the world. 

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Spirituality is different from religion, but is linked to it. Religion is about adhering to a set of doctrines that define each particular faith. Religion will often have a spiritual component – a worldview that has an idea of something greater than us (God, for example) and may also involve a spiritual connection as part of the religious practice. However, you do not need to be religious to be spiritual, and indeed being religious doesn’t need to be spiritual!

So how important is spirituality to our mental health and wellbeing? There has been a lot of research over the past decade that considers this question. The findings show that engaging in spiritual practices have a positive impact on our mental health. Lower levels of depression can be found in those who are actively involved in spiritual communities. Levels of stress and anxiety can be lowered by engaging in spiritual practices, and spirituality can be instrumental in the recovery from trauma. Also, there can be a greater sense of purpose and meaning from having a spiritual perspective, which can have a positive impact on our wellbeing. 

Having a committed spiritual practice – whether it is mediation, prayer, or whatever feels right for you – reading spiritual philosophy and engaging with a spiritual or religious community can be hugely beneficial in improving and maintaining positive mental health. Even if you don’t consider yourself to be spiritual, it is worth spending a few moments thinking about life and the wonders that we see around us. It is easy to see that there is more to life than our own limited worldview and when we step back and consider this, our problems and daily issues can be put into perspective as we gain a more holistic view of life.

 

Dr Simon Cassar is an integrative existential therapist, trained in Person Centred Therapy, Psychodynamic Therapy, Cognitive Behavioural Therapy (CBT), Dialectical Behavioural Therapy (DBT), and Existential Psychotherapy. He is available in our Hove and Lewes clinics and also works online.

 

Further reading by Dr Simon Cassar –

Living with borderline personality disorder

Online Therapy

Student mental health – how to stay healthy at university

Four domains – maintaining wellbeing in turbulent times

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Filed Under: Mental Health, Simon Cassar, Spirituality Tagged With: Mental Health, spirituality, wellbeing

April 8, 2019 by Brighton & Hove Psychotherapy Leave a Comment

Emotional Well-being

When most people hear the words ‘mental health’ perhaps what they are most likely to think of is mental difficulties, or mental ill-health.  I always think it’s such a shame that ‘mental health’ has these negative connotations, whereas just the word ‘health’ doesn’t seem to. 

I am a big believer in being proactive about mental health and wellbeing, and in the importance of doing things to stay mentally and emotionally well – just as you might keep active, eat a healthy diet and clean your teeth to keep your body well and healthy.  There is, perhaps unsurprisingly, a huge overlap between a person’s emotional and physical wellbeing. The negative impact of stress on health and wellbeing has been well researched. 

Positive Psychology is a branch of psychology founded by Martin Seligman, which is concerned with the positive aspects of life; it focuses on potential and thriving, or as one book puts it ‘positive psychology is concerned not with how to transform, for example, -8 to -2 but with how to bring +2 to +8’.[1]

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So, what might be the emotional equivalents of cleaning your teeth or keeping active be?  There are lots of ideas that can be helpful, and some will suit certain people more than others.  It is worth trying out a few different ideas to see what works well for you.  Using a planner can help, to ensure that you are regularly and frequently doing something specifically to have a positive impact on your emotional wellbeing.  It’s good to have a mixture of things across a week, including things that bring you pleasure and things that bring a sense of satisfaction or accomplishment. 

The list below includes different ideas and strategies drawn from Positive Psychology, and other areas of psychology:

  • Engaging in physical activity
  • Noticing your strengths
  • Actively relaxing – this could be using imagery, or a progressive muscle relaxation
  • Random acts of kindness
  • Spending time engaging in hobbies
  • Spending time with, and investing in close relationships
  • Completing the ‘Three good things’ exercise; every night for a week spend some time to identify and write down three things that were good about the day and notice your role in them
  • Thinking about someone you are grateful to or for, and telling them about it
  • Spending some time paying attention to the present moment (Mindfulness)

 

Please follow the links to find out more about about our therapists and the types of therapy services we offer.  We have practices in Hove and Lewes.  Online therapy is also available.


[1] Positive Psychology in a Nutshell, 2nd edition.  Boniwell, I. (2008).

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Filed Under: Brighton and Hove Psychotherapy, Mental Health Tagged With: Mental Health, therapy rooms Brighton and Hove, wellbeing

February 6, 2017 by Brighton & Hove Psychotherapy Leave a Comment

Four domains – maintaining wellbeing in turbulent times

Recent geopolitical events, notably the new American administration and the Brexit vote, can lead us to ever more uncertainty about the future. Facing this type of uncertainty can lead to anxiety about what the future may hold. Alternatively, we can experience despair and ultimately, depression about our powerlessness to affect what may happen in the future. While we may not be able to predict or have a big impact on what may be coming, we can do a lot to look after our wellbeing. This may enable us to face the future with a degree of equanimity.

 The concept of wellbeing is much spoken about, and can be viewed from a complex academic perspective. At the other end of the spectrum, it can become a rather glib, throwaway term. However, we can look after our own personal wellbeing by paying attention to four important domains in our lives. Putting a bit of effort into each can help us to feel better in ourselves and maintain a positive worldview.

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The Physical Domain

Looking after our physical health is a key part of wellbeing. For some, this is a part of everyday life. Going to the gym, running or playing team sports are great ways to increase physical fitness, and all enable us to feel more rooted in our body. However, this level of physical effort is not for everyone. We can do a lot to increase our physical health by simply walking a little more than we might do normally. This is promoted actively by the NHS, which outlines the positive physical and emotional benefits of being more active each day. 

It may seem daunting to reach the desired goal of 10,000 steps per day. However, merely increasing how much we walk each day takes us a long way towards increasing our physical health and fitness. For example, we might choose a longer route when we have to walk, stroll around the block after dinner, or walk up stairs rather than using the lift.

 Of course, increasing our physical activity is only part of the matter. We also need to consider our diet and aim to eat as healthily as possible, with plenty of fresh fruit and vegetables.

The Emotional Domain

Looking after our emotional health is also very important in improving our overall wellbeing. This can be as easy has having open and honest conversations with those who are close to us, which is a great way to deepen our relationships. Alternatively, writing a daily journal to explore our deepest thoughts and feelings can help us understand ourselves better and make sense of our inner world. Seeking professional help from a therapist is also an important step if our emotional world becomes overwhelming, or if we are unable to make sense of what is going on for us.

The Intellectual Domain

Our intellectual health is another very important area. It can often be overlooked once we have finished with formal education. However, keeping our minds sharp and alert to new ideas can be very inspiring and satisfying. It also helps us to approach the world from a fresh perspective. We can look after our intellectual health by taking a course (there are many free online courses available), reading an inspiring book that gives us new knowledge, or even by watching some of the short, powerful talks we can find on websites such as TED. 

The Spiritual Domain

The spiritual domain can often be overlooked, but can be hugely important to our overall wellbeing. For those who are religious, this can consist of spending a little more time in contemplation or prayer. For those who are not religious, spending a few moments each day in quiet meditation or practicing mindfulness (or even taking one of the many available mindfulness courses) can be very beneficial and can help to attain greater inner peace and an enhanced perspective on the world. If none of these appeal, you could simply spend a few moments each day noticing the beauty of the natural world around us.

Actively working for a short while in each of these domains every week can do a great deal to improve physical and mental energy levels. It can also give a sense of control of one thing we can have a huge impact on… our own wellbeing.

Dr Simon Cassar is an integrative existential therapist, trained in Person Centred Therapy, Psychodynamic Therapy, Cognitive Behavioural Therapy (CBT), Dialectical Behavioural Therapy (DBT), and Existential Psychotherapy.

Click here to listen to our podcast on this post. 

Click here to download a PDF version of this post.

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Filed Under: Simon Cassar, Society Tagged With: mind and body, self-awareness, self-care, wellbeing

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We would like to reassure all our clients that Brighton and Hove Psychotherapy is operating as normal despite the current situation.

Our working practices have fully incorporated online therapy in addition to a re-opening of our Hove and Lewes practices for face-to-face psychotherapy in accordance with Government guidelines and advice on safe practice and social distancing.