“I can’t wait to get up on stage and share my ideas, I’m going to be amazing”

“I’m really excited to get to work tomorrow and see what my boss does next, and how well I cope with it”

“I am really looking forward to the Christmas party where I know nobody and don’t speak the language, it will be an adventure”

Does this sound like you? Probably not, but it’s a great technique to help people conquer their fears by flipping their thoughts around from fear to excitement; from crippling to enabling.

The process of anxiety involves our brain surveying our environment, deciding there is a potential danger and flooding the body with stress hormones such as cortisol, the fight or flight sequence that enables us to respond quickly. Often this process is triggered by memories of times when we have felt fear, such as standing up to speak in public or entering a crowded room at a party where we don’t know anyone, and while there isn’t a life-threatening situation, our brain still reacts as though there is.

Of course, this isn’t necessarily true if we are facing a true danger such as being in the path of an oncoming car, when your brain needs to signal to your body that you need to save yourself. That’s when our anxiety system is working well for us. However, there are other times when it fails us, opportunities where we can be feeling fear about a situation to the extent that it becomes overwhelming, even crippling.

At these times, most people say take some deep breaths to try and calm down, but instead say ‘I am excited’. Here’s why this works - both fear and excitement are states of high arousal where the body is preparing for action, so it’s much easier to go from anxious to excitement than from anxious to calm, which is generally what we are asking our brain and body to do when we combat the fear with breathing or just avoidance (the latter can set us up for all kinds of problems down the road, so it’s generally better to avoid avoidance!).

Here are some things to remember:

• We all have things that make us anxious, so there is nothing unusual about your thoughts and feelings.
• We DO have control over our thoughts and feelings.
• When we get irrational fear-based thoughts and feelings, we need to grab them and deal with them before they settle down and decide to stick around
• Both the emotions of fear and excitement come from the same starting place, it is how we choose to respond to them that will inform our experience
• When you change a threat mindset to one of opportunity, from what could go wrong to what could go well, research shows that our performance improves, so take the high arousal and flip it around to your advantage.
  

Give this technique a try next time you feel anxious about something you are putting off or dreading and see what happens!

Dr Jules

If the subject matter in this article resonates with you, then counseling might be a good option to help you to move forward. I offer a free 20-minute consultation so we can explore how I might be able to help you. Find my details on the Contact page and drop me an email, and I'll contact you to arrange a no-obligation chat where you can tell me more about your problem and ask questions about the process of therapy.

Obsessive Compulsive Disorder (OCD) is a condition that is increasingly talked about, and many people now joke about being a “bit OCD” to explain a quirk such as a preference for things to be clean, ordered or tidy.

In reality, OCD is an anxiety related condition that can be extremely debilitating as it increasingly interferes with a person’s ability to function in normal life.  OCD is characterized by anxiety provoking persistent thoughts, worries or impulses, that are experienced as intrusive and not under the person’s control; while the compulsive element describes repetitive behaviours that the person feels compelled to carry out in an attempt to reduce the anxiety. While the person usually knows the thoughts are irrational, they nevertheless feel the compulsive behaviour is the only way to relieve the anxiety, or to stop any harm coming to someone they care about.

In the U.S. and U.K., it is estimated that about 12 in every 1,000 people are living with OCD, but this may be an underestimate as many people either don’t recognize the problem in themselves, or are too embarrassed to seek help.
Typically a person’s OCD will fall into one of four main categories:

• Checking
• Fear of Contamination
• Hoarding
• Ruminations / Intrusive Thoughts
  

Clients I have seen with OCD have displayed worries around using public bathrooms or certain supermarkets, leaving the house without checking everything numerous times, travelling on public transport or being in busy public spaces, to name just a few examples.

Brain scans of OCD patients have revealed there is a worry-circuit as several parts of the brain - notably the caudate nucleus, orbital cortex, and thalamus - tend to be running in overdrive.

Interestingly, there is a cultural element to OCD as in the West, people tend to worry about cleanliness and hygiene, or safety and checking things are switched off/locked, while in the Middle East it has been reported that OCD tends to be more commonly associated with the correctness of how religious rituals are observed. So, typically people develop OCD around more widespread cultural narratives, but the commonality is the power of the obsessions to shape and define behaviour.

While OCD is a chronic condition, it is also very treatable. Treatment is typically psychotherapy with a focus on cognitive-behavioural techniques to break the cycle of worry, and indeed research suggests that psychological therapy has a very biological effect on changing the way the brain works, enabling the client to take control of their thoughts and therefore change their behaviours.

If you have a concern that you or someone close to you has OCD, then I highly recommend you contact a counsellor or psychotherapist to help break the cycle before it becomes further entrenched.

Dr Jules
If the subject matter in this article resonates with you, then counselling might be a good option to help you to move forward. I offer a free 20-minute consultation so we can explore how I might be able to help you.

Lately it feels like every time we turn on the news we are faced with world events that are terrible but out of our control. How can we solve the Brexit situation? How do we stop gunmen killing children in schools in America? How do we end suffering in Syria? We feel we cannot ignore the chaos and hurt of the world, and yet it hurts us to witness it every day. Without considerable resources, we often feel powerless and frustrated to improve the world, and that can be incredibly stressful.

Despair is a common experience we all share. We feel it during difficult times in our lives. We sometimes despair about our work, our relationships, our financial situation, our love life (or lack of it), and of course we despair over world events each time we tune into the media. Typically, this feeling dissipates and quietens down until the next time, but sometimes it actually gets deeper, takes control of us, and forms a clinical condition where we constantly feel hopeless, pessimistic and powerless. Ultimately, we feel out of control.

We cannot control the government, the weather, other people’s opinions, our spouse, but we can take small steps so these feelings of despair don’t overwhelm us. This is generally true in counselling, where my clients are not always able to change the circumstances of their lives, but when they realise they can change the way they feel and think, it is significantly more empowering than continuing to think that if they could just control circumstances they’d feel better. We can’t un-do the past, but we can control how we deal with it in the now; we can’t control how others behave, but we can control how we react.
So how do we begin to take control when we feel despair at the world?

• An obvious way to take control is to limit our exposure to news that distresses us, whether it be the television or social media such as Facebook, learn to switch off when you start getting overwhelmed.
• Experts suggest we can instead think about how to improve things that matter closer to us, such as our home, family, community, etc. Sometimes we can become so consumed by the suffering of animals and people in other countries that we overlook what is happening within our neighborhood. What about old people who are living alone, or kids that need a steady and loving foster-home, or local animal shelters that need people to spend time with the dogs and fund raise so they have warm bedding? You might not have wealth in terms of money, but likely you have gifts and talents, such the ability to organize a bake sale, help in a neighbour’s garden, or write an email or letter of support and encouragement for someone who is going through a tough time.
• If you feel particularly powerless some days, then do something small such as cleaning your bathroom or having a turn out of your wardrobe, so you get a sense of accomplishment.
• Seek solace in other people. We can get lost in the fog that pervades our minds sometimes, and talking to a wise and trusted friend, or having a session or two with a counsellor, can help to clear that fog.
• Recognize when the best thing you can do is take care of yourself: eat, sleep, nurture yourself so you can regain some perspective.
• Be aware of signs that your emotional bank account is becoming exhausted. Those bad news stories about the world may be the final straw rather than the real cause of the problem. If you are more tearful or angry than usual, then you need to retreat and take stock so you feel less over-extended. Be honest about your priorities and where you are expecting too much of yourself.

Ultimately, we need to find ways to feel more in control and hopeful about the world, and our small place in it. A sentence that sticks in my mind from something I once read is that “people can live weeks without food, days without water, minutes without oxygen, but not a moment without hope”. And if you sometimes think the world is going crazy, you might be reassured to know that according to cognitive psychologist Steven Pinker, the human race is now healthier, more prosperous, and safer than ever before. The problem, he argues, is not the state of the world, it is our bias towards a negative representation of it. So, take heart, and take control of your thoughts, and the world will seem like a better place where courage and compassion can triumph over despair.

Dr Jules

If the subject matter in this article resonates with you, then counselling might be a good option to help you to move forward. I offer a free 20-minute consultation so we can explore how I might be able to help you.

These are worrying times and health professionals around the world are seeing a rise in rates of depression and anxiety (Daily Telegraph). In addition to people’s general everyday problems, we are being bombarded with stories about Brexit, political instability in the world, threats of nuclear war, and catastrophic weather events, to name but a few. We are increasingly isolated and feeling our sense of social support comes from online sources such as Facebook, the world where everyone else is having a great time.

When we start to feel overwhelmed with stress, there are ways we can begin to regulate our emotions, usually by choosing to tone down negative emotions such as worry. The key word here is ‘choose’. We can choose how we direct our focus and our energy, and that in turn will change how we feel.

Most of us already have tactics to help us feel better. We might go to the gym, meditate, put on music or mindless TV, or we might listen to podcasts and audio books while we go about our day. Here are some tips that you can add to your toolkit to help you reduce your worry load:

• Limit your access to social media from time to time. It’s great to be in touch with everyone, but sites such as Facebook have also become a place where people express opinions and say hurtful things, or post items others find distressing. At times the constant newsfeed can contribute to you feeling like you are on overload. It is not always, therefore, a helpful distraction, or a positive substitute for real human interaction. So, plan to take some apps off your smartphone and make your access harder, then you can tune in for limited periods just to be in touch with people that matter, without being distracted by the ‘noise’.
• Focus on your breathing. Take a moment to be aware of the air passing in and out of your body, keeping your mouth and eyes closed, and keep your mind focused on that sensation for five minutes if you can. Be aware of the sensation of the air on your nose and how the temperature changes as it enters your nostrils and passes down into your airways, then how it feels when you breathe it out. You can count when you breathe in and out if that helps you to tame your busy brain and stay focused on your breath.
• Do not ruminate. When I see anxious clients, they usually have a subject they are focusing on exclusively, often an area of their life where they feel out of control, and it causes their mind to race. An old trick to remind yourself when you are falling into this pattern is to put an elastic band on your wrist, and each time you find your mind going back to this unhelpful place, ping the elastic band on your wrist to give yourself a little ‘snap out of it’ reminder. Then ask yourself what is one thing, however small, that you can do to begin to take control of the situation? If it is a natural disaster, can you make a donation? If you are worried about how Brexit is affecting your life, can you sign a petition or write to your MP? Can you start to make a list of pros and cons for a potential decision, or talk to someone in the same boat as you? You might not be solving the problem entirely, but do something proactive and feel better about the fact that you turned worry into action.
• Don’t let your thoughts stay trapped in your head, where they seem to form a kind of seething soup of worry. Find ways to get them out. Writing them down often helps, as does saying them out loud when you are alone. Just reading or hearing them can help you start to make sense of them.
• Get out there and talk to people. Contact friends and tell them you need to catch up, go to a public event where you have people around you, volunteer to go and walk the dogs at the rescue center or help at a local foodbank, join a class or a group, or start one yourself. There are often plenty of people like yourself who might jump at the chance of a get fit or weight loss support group, or a regular book club to help get through the long winter evenings. So, if you don’t see what you want out there, then start it. In short, being around other people is good for mental health, while isolation is bad. And the old adage that a problem shared is a problem halved still holds true, so don’t keep your worries to yourself.
• If you find your worries and anxiety are starting to make you feel unwell or unable to cope, then go see your GP and consider seeing a counsellor. It isn’t always possible to do it by yourself, and even health professionals and therapists need some extra support now and then.
  

Dr Jules

If the subject matter in this article resonates with you, then counselling might be a good option to help you to move forward. I offer a free 20-minute consultation so we can explore how I might be able to help you.

In the last few weeks in France I have been coming across more cases of people who are isolated, either as individuals, or as couples who rely totally upon each other and rarely get out into the world. When you don’t speak the local language fluently it is all too easy to stay in your own little bubble. In general, our society is increasingly an isolating experience with more young people leaving home to live a single life, marrying later or becoming elderly and living apart from family. Many of us rely on social media and the internet to fill the void of real interaction, which can leave us vulnerable for a number of reasons.

The important thing to understand is that humans are pack animals. Our brains are hardwired for social interaction and living in a close community. Early humans did not live alone, they stayed in groups and worked together to hunt, make shelter, raise children and provide protection and support for each other.

Even though we have evolved in many ways since then, research confirms that being isolated and feeling alone is not good for our health. Lack of emotional support and regular interaction with others has been shown to increase anxiety while gradually decreasing our ability to cope. When we are alone too much our level of stress hormones increases, which can lead to a poor quality of sleep and a compromised immune system. In elderly people, isolation also leads to cognitive decline, as monotonous lack of stimulation day in and day out can cause people to turn their attention inwards far too much. There is a good reason why solitary confinement is considered a cruel and unusual form of punishment in prisons!

The evidence is clear that connection with other people is essential to health and those connections need to be meaningful and with a variety of people who challenge and support us in different ways. Whether you are in rural France or a big city in the U.K., it is vital to avoid prolonged periods of isolation. Seek out more social contacts, get to know your neighbours, learn the local language, find voluntary work, take an evening class, start a book club or a new hobby, talk to your spouse about how you can get out more as a couple and as individuals … in short find ways to build relationships and reduce seclusion, and take care of your mental health.

Dr Jules

If you are feeling stuck in your life, counselling can help you to move forward. I offer a free 20-minute consultation so we can explore how I might be able to help you. Please contact me via the Contact page to discuss whether counselling is right for you.

This week I answer a reader's question about her feelings of betrayal:

Dear Dr Jules

I wonder if you can help? I feel I have been betrayed most of my life, personally by more than one partner including my husband, and now also professionally. I trusted some work colleagues who have both let me down. I have got to the point where I just feel like shutting down my business because of it.

Hi there,

Betrayal is something that happens to all of us at some point, but it’s a tough lesson to face as at the root of all betrayal is a violation of your trust, and that hurts.

Regardless of whether it’s a romantic partner who leaves you unexpectedly, a friend who spreads vicious gossip about you, or a business deal where you get ripped off financially, the root of all of them is the fact that you gave your trust to those who were not worthy of it, and you are left feeling that you have no control over the situation. This can affect your self-esteem as well, as you can start to wonder if the people who have betrayed you ever valued you in the first place.

So what can you do to start feeling better after a betrayal? While we can’t change the situation and what has happened to us, we can change how we see it, so here are some tips to help you:

1. Start by asking yourself if these people were worthy of your trust, and how much should your sense of yourself depend on their actions? Reflect on this for the future as well, so that you choose the people you share your trust with wisely.

2. Keep good boundaries and do not allow a climate for betrayal to form. Be clear about your expectations from people and be open with your communication to them so they know where they stand and don’t have the opportunity to behave in ways that you would find unacceptable.

3. Don’t fixate on the past or dwell on how you were wronged and what might have been – channel your thoughts to the present and future and how you want things to be from now on. The anger can only fester in you if you let it, and that will cause you pain and hold you back. Retaliation can seem sweet in the moment, but you might be surprised how much of your time and energy you are devoting to fantasizing about your revenge, and sadly that is only detracting from time you could be spending on doing something positive for you or people who deserve it.

4. Let go by writing your thoughts about the betrayals down on paper and then flush it away in the toilet or burn it.

5. Build trust in yourself and your choices, and let go of people who you find untrustworthy, then put your energy into people who you know won’t let you down.

Ultimately, you can learn to see betrayal as a fork in the road where one direction leads to bitterness while the other leads to opportunity. Be kind to yourself and your pain, and in time you will move forward with your plans again.

Dr Jules

If this topic resonates with you and you think I might be able to help you through Counselling, please get in contact. I offer a free twenty minute chat so we can decide if counselling with me is right for you.

This week a reader writes in for help with a phobia, and the advice will be helpful to anyone who feels their life is limited by fear:

Dear Dr Jules

I want to see my family in the UK but I hate boats and I am afraid of flying - I tried someone hypnotising me but it did not work. It makes me feel like a prisoner. Please help.

Hi there,

I’m sorry to hear about your dilemma and understand how trapped you must feel. You are describing the experience of someone with a Phobia. A phobia is a strong persistent fear of a situation or object, that is not normally seen as overly dangerous. This fear gives you an overwhelming desire to avoid certain situations, even though part of you knows it is not rational. Phobias can be really disabling and can interfere with normal everyday life, as yours is in stopping you from travelling to be with loved ones.

Symptoms of phobias include classic fear responses such as a rapid heartbeat, trembling, breaking out in a cold sweat, feeling nauseous, all similar to a panic attack. Generally, people try to get away from whatever it is they are afraid of in order to decrease the bad feelings, but repeated ‘fleeing’ only serves to reinforce the fear in your brain.

It might help you to know that many people have phobias, although they don’t often talk about them. People can be fearful of many things such as spiders, heights, flying, public speaking, crowded places, or the sight of blood, to name just a few. When I am flying I often observe the other passengers and notice which ones are holding onto the arm rests that bit more tightly during take-off and landing, as even though flying is now common place, many people remain anxious or even avoidant of travelling in planes. Phobias are generally thought to be a learned fear, for example if a person gets bitten by a dog they may start avoiding dogs to the point where they become phobic about being around them. Sometimes it is a one-off event like this that starts a phobia, or it may be a fear that builds gradually, or that starts during a time of general stress when emotional arousal is already high. It might be helpful to know, though, that we don’t need to know the exact cause to treat a phobia successfully.

Treatment of phobias varies according to the type of phobia, but it usually follows a more behavioral path of desensitization where the cycle of fear is broken. Gradually through supportive therapy a person is helped to face the things they fear and re-learns how to deal with them more effectively. Some people find hypnotherapy helpful, but generally a solid treatment plan with a therapist who is experienced in working with anxiety and phobias will yield positive results in a relatively brief number of sessions.

So, to answer your question about your fear of flying or travelling by sea, there is hope and you don’t need to remain a prisoner forever. I have successfully worked with a wide variety of phobias over the years, including fears of flying, crowded public spaces and even a client who had a phobia about his local Sainburys! All of these clients were helped to gain control of their fears and move forward with greater confidence. The first step to getting rid of the fear is to make the decision to do something about it, and by writing in you are already on the path to change, so I encourage you to keep that momentum going. Bon chance!

Dr Jules

If you are suffering with an anxiety related problem, then counselling can help you to move forward and make positive changes. I offer a free 20-minute consultation so we can explore how I might be able to help you.

This week I take a look at shyness. Research suggests about 90% of us say we have felt shy at some point, such as when we have to walk into a room full of people we don’t know, but many of us have figured out a defense system such as laughing or talking a lot. For some people this shyness develops into a more problematic situation and about 13% of the population could be diagnosed as having social anxiety, where our apprehension of being around others starts to inhibit areas of our life. It is a bit like imagining we each have a shyness thermostat inside us that leads us to interpret social situations with differing levels of fear, ranging from minimal to overwhelming.

Symptoms of higher levels of shyness or social anxiety include: blushing, sweating, shaking, racing heart, avoidance, apprehension of being around other people, self-consciousness, avoiding eye contact, appearing quiet and isolated at social occasions (which can also make you appear superior or you can be labelled anti-social), fear of being embarrassed or rejected, and in general being there without really being there.

Over time, if the anxiety continues we become conditioned to associate others with our fearful reaction and unpleasant feelings, and because we anticipate a poor outcome we avoid what we assume will be a loss in terms of creating relationships. This distancing from people before we even give them a chance means that we lose the opportunity to seek pleasure from a sense of affiliation as well as the chance of closeness with people who could become more important to us.

Imagine a teenage boy who is starting to have opportunities to interact with girls, and feeling a great deal of anxiety to the point where he freezes whenever he is around them. He then starts to avoid girls so he can feel less anxious, but over time as he compares himself to other boys this feeds into his sense of self, and his internal thoughts are that he is ineffective and unmanly. Eventually he pushes himself to go to a party and has a few drinks to try and calm himself down, but when a girl tries to talk to him he feels overwhelmed and leaves in a hurry. Word gets around his social circle that he is weird or possibly gay, which leads to him becoming even more isolated and then he starts showing signs of being depressed. It can be too easy to spiral into a self-defeating situation.

It is important to remember that humans are inherently social animals; we evolved to thrive on having a relational group to exist within, and if you do therefore find yourself becoming isolated in a way that leads to you to feel unhappy then here are 10 tips to help you:

1. To overcome your shy feelings, you need to act in the opposite way, e.g., be non-fearful and outgoing. Make a list headed ‘How would I act if I was not shy?’ List all the behaviors people would see, e.g., making eye contact, smiling, being communicative. Then go out and practice, practice, practice, and keep a note of the level of discomfort you feel each time. Over time your discomfort level will decrease.
2. Find a common interest group so you already have something to talk about, and when you find that group commit to yourself that you will keep showing up rather than making it a one-time deal.
3. Communicate via social media some of the time so you can express yourself without that awkward feeling you get in person. This will help you to build some rapport and commonality with people you are interested in developing an association with.
4. Test out whether your shyness thermostat has become set too high by going to a social occasion that you would usually avoid, and then compare your expectations with what actually happened, e.g., “I expected nobody would want to talk to me, but I struck up a conversation with someone and it went well”.
5. Vow to test out your hypothesis that ‘other people are a potential risk’ with each new person you encounter. Most people will be okay, but know that if they prove your hypothesis to be correct by behaving badly then that says something about them, and not about you.
6. Volunteer to take a role or to host, as this allows you to approach others at the event with specific requests, such as asking them to come and eat or pose for photos. Having something to talk about or a role you have to play can be a helpful way to ease into social occasions.
7. Make a 10% change in your behavior, such as asking one more question in class or sitting one row closer to the front, and then when that proves to be survivable, make it another 10% next time.
8. Think of open ended questions ahead of time so you have something to say, such as “how did you both meet?” or “I’m looking for something decent to read, what books have you read lately that you would recommend?” Know that lots of people are either hoping someone else will take the lead, or they like talking about themselves and appreciate the opportunity!
9. Take a deep breath and commit to see a good therapist who will support you through your transition to setting your thermostat from socially anxious to liking yourself and being comfortable around other people.
10. Remember that shyness is not valued in our society, whereas being assertive and extrovert is. In fact though, shy people can be more sensitive to what is going on around them and they often make keen observers of others, which can be a skill in many areas of life. Think about this quote by John Amodeo from his book The Authentic Heart: "If you experience shyness, consider it a blessing. Shyness is an entrance into a tender fold within your authentic heart … If you can allow yourself to experience shyness when it arises—if you can gently turn your attention toward the place in your body that feels this shyness—then it becomes a friend, not a threat. Embraced shyness transforms into sweetness … As your tolerance for shyness grows, there are greater possibilities for breakthroughs into the exhilarating pleasure of connecting."

Lastly, remember that while Facebook makes it seem as though everyone except you has hundreds of friends, in reality most people have just a couple of people they can call true friends, and it is those connections that count. Focus on being more socially comfortable and eventually you will make the acquaintances that lead to real friendship.

Dr Jules

If you are facing a challenge in your life because of social anxiety and can’t see a way forward, then counselling can be helpful in providing support and a non-judgmental space to learn to find balance and confidence. For more in-depth help and counselling, consider contacting me in person. I also invite questions to be answered on my blog.