Compassion for All – Including You

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The Buddha taught that we should have compassion for all living beings: every bird, animal, fish, insect... and human on this planet. This is not easy. Leaving aside the thorny question of what we are supposed to eat if we take this idea to its logical extreme, let's focus on people, because that's complicated enough.

For example, it's easy to feel compassion for those we love or like. We can forgive those closest to us pretty much anything, because we have such a strong bond with them.

Our friends, parents, siblings, children, spouse – if we are lucky enough to have good relationships with these people, feeling compassion for them is not hard. But what about that colleague you don't get on with at work – the one who talks about you behind your back? Or the guy who just cut you up in traffic, nearly causing a nasty accident?

Taking it one step further, how about politicians like Donald Trump who promote violence and racism? Should we really feel compassion for him? And harder still, how about a murderous dictator like Stalin or Hitler – surely they are the last people on earth we should feel compassion for.

Compassion for all

As someone who is passionate about Buddhist psychology's depth, richness and practical wisdom, I have long struggled with this idea. But as far as I understand it, the Buddha would say that we should feel compassion for everyone, even those we find abhorrent, because the alternative is to fill our minds with hatred, anger and hostility, which he called poisons of the mind.

If I spend my days hating Trump, who suffers? Not him, for sure. I can fundamentally disagree with his odious behaviour without succumbing to hatred – instead, I can wish for him to change, to become a less hate-filled and harmful person, because that will reduce the suffering he causes in the world.

And I can't believe that anyone who is so full of anger and hatred is truly happy; so I can have compassion for their unhappiness without approving of the person in any way.

Compassion for yourself

If this all seems hard to grasp, surely it's easier to think about feeling compassion for yourself? Sadly, in my experience of helping people with all sorts of psychological problems, this is neither simple nor easy. Time and time again I am saddened by the harshly critical way in which people talk to themselves in their minds.

They call themselves names like 'idiot' or 'failure', say they are 'pathetic' or 'crazy' or worse. And this, of course, creates suffering – research shows that harsh self-criticism is linked with depression, low self-esteem, anxiety, eating disorders, anger-management problems, and more.

So a key focus with all of my clients is encouraging them to be kinder to themselves. Mindfulness meditation really helps with this, as do a wide range of cognitive and schema therapy techniques. But you can start today, simply by catching yourself using harsh words when you speak or think about yourself.

Ask the simple question, 'Would I talk to my best friend like this?' If the answer is no (and it almost always is), try speaking to yourself a little more kindly. It could make a huge difference to the way you feel day to day.

Warm wishes,

Dan

Yoga and Mental Health

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As a late convert to yoga, I cannot recommend it highly enough. Having dabbled with ashtanga yoga a decade ago, when I wasn't quite ready for it, I thought it was a good idea to try again.

And I'm so glad I did – the benefits for my mental and physical health are tremendous. My back pain has vanished, I feel physically stronger, calmer and much more relaxed on a daily basis.

Intriguingly, I recently learned that the main purpose of hatha yoga (the physical postures, which are actually just one aspect of yoga practice) was originally to prepare for meditation – developing the flexibility, stamina and settled mind required for extended periods of sitting. And yoga certainly dovetails perfectly with my daily meditation practice, each enhancing and strengthening the other.

If you – like most people in the West – suffer from stress, yoga is for you. And if you have any physical health conditions, such as headaches, digestive issues or back pain, yoga can help with those too.

It may be more difficult to commit to any form of regular exercise if you are struggling with more serious mental health issues, such as depression or an anxiety disorder, but if you can try even a little yoga – say once or twice a week – it will really help.

Exercise combats depression

There is a large body of evidence showing the benefits of physical exercise for all psychological problems. For example, regular cardiovascular exercise like running, weights, playing sport, cycling, swimming – or more strenuous forms of yoga, such as vinyasa or ashtanga – is proven to be just as effective as antidepressants for mild to moderate depression. With no side effects (well, apart from feeling happier, healthier and more relaxed!).

If you do have a mental health problem, I would not recommend either meditation or yoga as a substitute for proven treatments like cognitive or schema therapy; but they are excellent additions to Western psychology. And, of course, Eastern practices like mindfulness meditation are increasingly used as part of talking-therapy treatments such as schema therapy or CBT.

Warm wishes,

Dan

Finding Your Way Through Depression

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When you get depressed, it's easy to think you are the only person who has ever felt this bad – but anyone can become depressed, especially when they suffer a major loss such as bereavement or divorce. Depression can also be a response to feeling overwhelmed by life, when the stress or upset are just too much to bear. Even the strongest of us have our limits, so when we take on too much, or life overloads us with problems, it’s easy for our mood to dip.

When you are feeling depressed, it's easy to imagine that everything is hopeless, or that you will never get better. You may be tired all the time, unable to sleep properly, taking little interest or pleasure in the things you used to enjoy. You might feel angry or irritable about every little thing, or be fearful and anxious for no obvious reason. You may also have suicidal thoughts, which are very common when we are depressed.

It’s important to distinguish between different kinds of depression. Mental health professionals talk about mild, moderate and severe depression, which are just ways of distinguishing between how much it is affecting you, your day-to-day mood and ability to function. I think it’s also useful to recognise that some people only ever have one episode of depression – usually in response to a loss or life crisis – while others have ‘chronic’ depression, which means they experience repeated bouts of low mood for years or even throughout their life.

There is much debate about what causes depression, but in the cognitive therapy model we see depression as a result of persistent negative thinking, which may be triggered by a painful life event, but is also linked to underlying negative beliefs.

Negative beliefs are key

Aaron Beck, the founder of cognitive therapy, calls these beliefs the ‘cognitive triad’, meaning negative beliefs about yourself, your experiences and your future. These beliefs may lie dormant throughout your life, until they are triggered by a loss or crisis, when they become active and start to dominate your thinking.

People with depression use all sorts of images and metaphors to describe their experience, but commonly talk about viewing the world through dark glasses, being under a black cloud, or everything looking grey (Winston Churchill, one of many famous people who have suffered from depression, talked about the ‘black dog’ that followed him everywhere). These images reflect the overwhelmingly negative bias to your thinking when you are down, making everything seem a bit bleak, hopeless and too much to cope with.

Withdrawing from the world

When you are depressed you also stop doing the things you used to enjoy, like going to movies, spending time with friends or cooking delicious food. This is absolutely normal, and in many ways perfectly understandable, because these things no longer give you any pleasure, so why would you bother?

You may also be exhausted, so lack the energy to go out and engage with the world. More than that, you might find interacting with other people difficult or even painful, so again it makes sense to withdraw from your relationships with others.

The key point here is that, although completely normal and understandable, when you stop doing things you used to enjoy or seeing other people you get increasingly withdrawn and isolated. If you spend all day in bed, you will probably not be resting, but instead engage in ‘rumination’, with all those dark thoughts going round and round your head.

Think of it this way – who wouldn’t get depressed if they never did anything fun and spent all day thinking about everything that was wrong with them and their lives?      

Re-engaging with life

So one of the first things I do with depressed clients is to help them start doing things again – very gently at first, but slowly re-engaging with life. If you are really down, this might just be doing the laundry and tidying your flat; for other people it may be doing some gentle exercise, cooking at least one healthy meal a day, or planning a trip so they have something to look forward to.

Gradually their mood lifts until they feel well enough to tackle those negative thoughts – again, slowly and steadily, but persistently examining and talking back to the thoughts that tell them they are rubbish, hopeless or a failure. Over time they realise that once they take off those dark glasses, they can see life is not so bleak, that there is hope and that – with a little help, guidance and support – they can find a way through depression.

Warm wishes,

Dan

Bibliotherapy for Depression

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'Bibliotherapy' is an important part of cognitive therapy, either to run alongside a course of therapy or as a self-help tool. I often recommend books to my clients, partly because there is only so much time in a session, so it's much more useful for them to read up about their particular issue and for us to discuss their findings next week.

But I also find that many people like to understand why they might be having problems and find their own strategies for solving them – another important idea in cognitive therapy, because ultimately I want my CBT clients to be their own therapist.

You can read one or all of these books, depending on which appeal to you. You can also read the whole book or dip in to the chapters that seem most relevant to you.

1. Overcoming Depression: A Self-help Guide Using Cognitive Behavioral Techniques, by Paul Gilbert. Part of the excellent Overcoming... series, this is written by one of the world's leading experts on depression. It explains perhaps better than any other book I have read on depression exactly why we get depressed, with particular emphasis on the way our brains are wired to make us vulnerable to depression when we are threatened, or suffer major losses in our lives.

   Warm, compassionate and eminently readable, this book is also full of practical tools and techniques you can use to tackle your own low mood, with or without the help of a CBT therapist.

2. The Mindful Way Through Depression: Freeing Yourself from Chronic Unhappiness, by Williams et al. This also serves as the perfect introduction to mindfulness meditation, if that interests you – and comes with a CD of guided meditations by Jon Kabat-Zinn, one of the leading figures behind the marriage between mindfulness and modern psychology.

   As well as providing a wealth of information about why we get depressed and what we can do about it, this book is based on the principles of mindfulness-based cognitive therapy (MBCT), an eight-week meditation programme that research shows is highly effective at treating recurrent bouts of depression. Like Gilbert's book, it is warm, wise and kind-hearted, so is a soothing companion when you're feeling down. 

3. Mind Over Mood: Change How You Feel by Changing the Way You Think, by Dennis Greenberger and Christine A. Padesky. This seminal book remains the best introduction to CBT, almost 20 years after it was first published. Although not written specifically about depression (it is just as useful for any of the other issues mentioned above), if you are suffering from low mood it offers a clear, simple, step-by-step guide to modifying the negative thinking that is at the root of depression.

   Padesky is perhaps the world's foremost CBT therapist (she was taught by and remains very close to CBT's founder, Aaron Beck), so you can rest assured that the techniques and strategies outlined here are to be trusted.

Warm wishes,

Dan

Feeling Stressed or Depressed? Go Easy on the News

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The media has always portrayed the world through a distorted lens, focusing on and exaggerating bad news, while ignoring or discounting the good. But before 24/7 rolling news and the rise of digital media, it used to be much easier to filter out all the scary, upsetting things happening around the world.

Now, they are very hard to avoid – look at any news website, watch TV or check your Facebook feed and you are bombarded with stories that can make the world feel like a scary, dangerous place. It's easy to feel that we are under threat too, which is not helpful if you are prone to anxiety, as you probably over-perceive threats to your safety or wellbeing already.

Although we do face some really unpleasant and frightening threats right now, it's important to remember a few things:

1. We are living through the safest, least violent period in human history. Despite what the media might tell you, crime rates in the West have plummeted over the last 50 years. If we are lucky enough to live in a stable, Western democracy, we are actually extremely safe.

2. Although there have been a spate of truly awful terror attacks throughout Europe, this is not a new phenomenon. I grew up in London, which faced constant threats of attack and regular bombings by the IRA; other terror groups were active throughout Europe, so without downplaying how shocking and horrible the recent attacks have been, we have lived through similar problems before. And the probability of you being involved in a terror attack now is still extremely low.

3. Fear sells. The media have long known this and, sadly, some sections of the media – especially tabloid newspapers – have lost any semblance of caring about their readers' wellbeing, printing lies, mistruths and highly distorted versions of reality that make everything seem frightening and bleak.

   Just take their treatment of the refugee crisis as an example, or the blatant lies and fearmongering that persuaded so many people to vote for Brexit. 'Never let facts get in the way of a good story,' as the old journalists' joke goes. 

4. If you are struggling with any kind of mental health problem – like stress, anxiety or depression – it might be good to take a news break for a couple of weeks. Reading upsetting stories, or watching violent movies/programmes is not good for your brain, as it will ramp up your feelings of insecurity, fearfulness and being under threat.

   Be kind to yourself and take a break – remember that just a couple of hundred years ago humans would mostly only get news about their extended family and local community, by word of mouth; no lurid headlines or minute-by-minute coverage of shocking events across the globe. Our brains are not designed for this media bombardment, and countless studies show the negative impact it has on our psychological health.  

So, if you are having a hard time right now, treat yourself with care and either limit or give up your news intake completely for a while.

Warm wishes,

Dan

5 Myths About Mindfulness Meditation

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It's wonderful that mindfulness has gained so much popularity in recent years – it's hard to read a newspaper or Sunday supplement without finding a story extolling the benefits of meditation. Unfortunately some of these stories are not entirely accurate, and many people have misconceptions about what meditation is and how it can help.

Here are five of the most common myths and misunderstandings I hear about meditation, to help you gain a clearer insight into this potentially life-changing technique:

1. Meditation is just for Buddhists

Not so. Although mindfulness meditation is a 2,500-year-old Buddhist technique, it is increasingly used in Western psychological, medical, educational and business settings. If you learn meditation from me, or another therapist, you are essentially learning a technique, like using thought records to challenge unhelpful thinking.

Although I do have a strong interest in Buddhist psychology and philosophy, I only talk about that to my clients as far as they are interested in it. So you don't have to believe in any form of religion to benefit from mindfulness, all you have to do is sit quietly for a short period every day and watch your breath. That alone is proven to have a raft of benefits, from reducing stress and anxiety to lowering blood pressure. Simple.

2. You have to clear your mind of all thoughts

Again, no. If your mind is empty of all thoughts, you have a very unusual mind indeed. We are always thinking – even when we sleep – so the idea that we should somehow magically stop thinking when we meditate is neither helpful nor realistic. Instead, if we are trying to focus on our breath, say, when we find our mind carrying us off into thinking about lunch, we notice that and gently bring our attention back to the breath.

Again, again, again – it might happen 100 times during a 20-minute meditation, but that's not a problem at all. In fact, this is the practice, because each time you notice and bring your attention back, you are strengthening your ability to focus, which is the whole point of meditation.

3. You have to meditate somewhere quiet

In some ways, this is true – it's helpful to meditate in quiet places, for example at home in the early morning. But mindfulness is a skill we are trying to cultivate for when we need it – on the Tube, in a meeting, in a shopping centre. So the more you practice in everyday situations, the more that skill is available to you when you most need it – like your toddler having a meltdown in the supermarket.

I often meditate on the Tube, because it can be an unpleasant place – noisy, packed with people, hot, glaring lights... Far better to close your eyes and focus on sounds, say, than ride along grimly trying to ignore it all.

4. Meditation should always make you feel relaxed

Sometimes yes, sometimes no. There's a saying in Zen meditation: 'Just sit'. This means just meditate, every day: hard/easy, enjoyable/frustrating, relaxing/no change. It doesn't matter, because we meditate for the long-term benefits of daily practice.

If you do it most days for a period of time, you will probably feel calmer, more grounded, less stressed, happier, more able to deal with stressors without reacting impulsively or unhelpfully. That's why we do it (and why I have, most days, for six years now – and will for the rest of my life).

5. Meditation is New Age hocus-pocus

It's true that meditation conjures up images of bearded, be-sandalled folk, incense and crystals. But mindfulness meditation, as well as having that 2,500-year history behind it, has been rigorously studied and researched in prestigious medical establishments since the 1970s.

There is a huge body of research proving its effectiveness for a wide range of psychological problems, such as stress, anxiety and depression; and for medical problems like chronic pain and high blood pressure.

Warm wishes,

Dan

Bibliotherapy to Help With Your Stress

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What is bibliotherapy? Well, health professionals increasingly see the benefit of reading for people suffering from a wide range of physical and psychological problems. In fact, a Government-backed scheme – Reading Well Books on Prescription – 'prescribes' specific books for people struggling with, say, depression or worry through their GP.

I have always recommended books to my clients, so this post is part of my ongoing bibliotherapy series (here are my posts on the best books for anxiety, mindfulness, compassion, anger issues and depression).

If you are suffering from stress, you will find these books helpful in managing your stress levels:

1. The SuperStress Solution: 4-week Diet and Lifestyle Programme, Roberta Lee, MD. Dr Lee is an integrative physician, which means she combines the best of evidence-based Western medicine with strategies and techniques from alternative approaches, focusing on meditation and relaxation techniques, sleep, exercise, work/life balance, diet and nutrition.

   Her argument is that the kind of stress those of us living a 21st-century urban life now suffer is far worse than our parents faced, so it has evolved into SuperStress; a type of chronic stress that is insidious and creeps up on us, given the constant drip, drip of stressors such as 24/7 digital media never letting us relax; the pressure to be perfect parents, partners, family members and employees; the endemic lack of job security; too much sugar, caffeine and alcohol; insufficient sleep and rest; and rolling news bombarding us with scary and upsetting stories. Her argument is very persuasive and it's an excellent book, so highly recommended.

2. 2. How to Deal With Stress, Stephen Palmer & Cary Cooper. This is a sensible, practical guide to reducing your stress by two world-leading experts in stress management. Having trained with Stephen Palmer at the Centre for Stress Management, I can personally vouch for his expertise in this area (he is also an excellent CBT therapist).

   The authors explain how to identify the cause of your stress, then offer a plan to help manage it. They offer practical guidance on time-management (hardly a scintillating topic, but important if you have a never-ending to-do list and not enough time to do everything on it), exercise and relaxation techniques, as well as nutrition. It's also the shortest of the three books listed here, so is helpful for the time-poor.

3. 3. Overcoming Stress: A Self-help Guide Using Cognitive Behavioral Techniques, Leonora Brosan and Gillian Todd. When I start working with someone using CBT, I always recommend a book from this Overcoming... series, as they are all written by leading CBT experts in their particular field.

   Not only will this give you an excellent introduction to stress and its physical, psychological and behavioural impact on you, but it will also explain CBT and how it works; with a particular emphasis on the role of unhelpful thinking in driving your problems with stress.

Warm wishes,

Dan

Is Schema Therapy the Right Approach for You?

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

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

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

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

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

CBT or schema therapy?

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

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

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

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

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

Warm wishes,

Dan

What is Cognitive Therapy?

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

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

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

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

How cognitive therapy works

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

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

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

So is cognitive therapy purely a short-term approach?

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

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

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

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

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

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

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

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

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

Warm wishes,

Dan

Dealing with Self-Criticism

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What makes you unhappy? Why do you get angry, stressed, anxious or depressed? Do you struggle with a lack of confidence or self-belief? And do you ever feel dissatisfied and convinced that there must be more to life than this, if you only knew how to achieve it?

The answers to these questions are as unique and multi-layered as humanity – I cannot know you, the wounds you may carry from childhood, or the ways in which your family shaped you, both good and bad. And I wouldn't presume to know, without spending time with you and hearing your story.

But the more time I spend helping people become stronger and happier, the clearer it becomes that a harsh, unkind inner voice lies at the root of many of my clients' problems. This 'inner critic' is often so powerful that people cannot distinguish its voice from their own.

We are all many people

But the human mind is exquisitely complex. We are not just James or Jane, but many people: we are parents, siblings, colleagues, bosses, lovers, friends, sons and daughters. We are both our adult selves – reasonably strong, capable and with a logical world view – and our child selves.

These younger versions of us are often vulnerable, dominated by powerful emotional needs and demands, with no sense of fairness or logic. When we lash out with rage or are broken-hearted and bereft, we have regressed into these younger parts of us, until we can find a way back to our adult selves.

And one part of us, which often speaks louder than the others, is our inner critic. Depending on our upbringing, the way our parents behaved with and spoke to us, and the beliefs we now hold about ourselves and the world, this critic may be mild and persuasive, like a kindly teacher.

Or it might be vicious, an inner bully that attacks us every time we fail, focusing on our weaknesses and belittling our strengths and achievements.

Driving a fear of failure

I often tell my self-critical clients to imagine someone standing next to them, muttering harsh words into their ear throughout the day. How might that make you feel? Depressed, perhaps, because you're clearly a terrible person with no redeeming qualities at all? Or anxious, because you live in constant fear of getting it wrong?

So transforming your inner critic is vital for good mental health. One way to do this is to use techniques adapted from Buddhist psychology, which Western mental health professionals such as myself are now embracing because they work so well. Read The Mindful Path to Self-Compassion: Freeing Yourself from Destructive Thoughts and Emotions, by Christopher Germer, if you would like to know more. 

Warm wishes,

Dan

How to Improve Your Self-Esteem

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If you had to describe yourself in a few words to someone you had never met, what would you say? Would you use words like smart, funny and lovable? Or stupid, useless and pathetic? Sadly, if you have low self-esteem, you are far more likely to opt for the latter three – even if they bear no relation to your true self, or the words your friends would use to describe you.

At its simplest, self-esteem is the extent to which we respect and value ourselves. If the way you perceive yourself is critical or unkind, your self-esteem is likely to be low, causing a host of problems – from a lack of confidence and self-belief to depression, anxiety, underachievement, addiction, problems with anger and self-destructive behaviour.

Developing self-esteem

Self-esteem – or the lack of it – is inextricably linked to our childhood and family dynamic. Along with keeping us clean, safe and fed, it’s our parents’ job to make us feel lovable and worthwhile. Especially when we are infants (because that’s when our sense of self, as a separate entity to our mother, is developing), they do this by giving us lots of physical affection, playing with and singing/reading to us.

As we grow they reinforce this by taking an interest in and praising us, both telling and showing us how much we are loved, wanted and important to them. If we are lucky enough to get this kind of parenting, we will emerge into adulthood with an strong set of interconnected beliefs that we are worthwhile and deserve all the good this world can offer us.

Problems with self-esteem in childhood

But you, like many other children, may not have been so lucky. Your parents might have been distant or emotionally unavailable. They might have criticised rather than praising you. They may have had mental health problems, been addicted to alcohol or drugs, or punished you overly harshly.

If so, you would have been profoundly hurt and confused. Why were they treating you this way? It must have been, you concluded, because there was something fundamentally bad or wrong about you.

As you grew up, if that treatment persisted – and perhaps was echoed in the wider family or at school – your sense of self would have been affected. And as an adult, if you believe you are a bad person and deserve bad things to happen to you, it’s incredibly hard to be positive and outgoing; to forge loving relationships or find lasting success.

You are likely to see the world through grey-tinted glasses, seeing only the bad in it and yourself. It’s hardly surprising that low self-esteem is at the root of many forms of mental distress.

Low self-esteem can be unlearned

But it doesn’t have to be this way. As low self-esteem is learned, so it can be unlearned. Cognitive therapy is an effective treatment for low self-esteem, because it helps you challenge and modify the negative, self-critical thoughts and beliefs that keep you feeling bad about yourself long after your cold or neglectful parents, nasty teachers and school bullies have faded out of your life.

I strongly recommend Overcoming Low Self-Esteem: A Self-Help Guide Using Cognitive Behavioral Techniques, by Melanie Fennell. The books in the Overcoming… series are all excellent, but this is one of the best. If you have low self-esteem, it explains how this developed and how your adult thinking and behaviour stops you from shrugging off negative early experiences and embracing life.

Most importantly, it gives you simple, effective techniques you can use every day to feel better about yourself, boost your mood and increase your self-confidence.

Warm wishes,

Dan

How to Manage Your Anxiety

Image by Faye Cornish

Along with depression, anxiety-related problems are the most common form of psychological difficulty. These problems range from mild to severe and include everything from a tendency to worry too much to potentially crippling problems such as severe health anxiety or obsessive compulsive disorder, which can completely dominate someone’s life.

Whatever form of anxiety you struggle with, the first thing to realise is that anxiety is both normal and necessary. Anxiety is an ‘arousal emotion’ which serves as a sort of alarm bell to warn us that something is wrong and we need to take action.

Fight-or-flight response

It is linked to the fight-or-flight response, a vital but primitive self-protection strategy that served humans well when we were surrounded by hungry predators, but is less well-adapted to the complex demands of 21st-century life.

All anxiety-related problems involve some kind of misfiring of this ancient part of our brains and are all linked to two things: overestimating threats and underestimating our capacity to deal with them. Let me give you an example – if someone has a phobia about dogs, they are likely to perceive all dogs as threatening, perhaps vicious and dangerous.

This is clearly an overestimation of the threat presented by the vast majority of (friendly, tail-wagging) dogs. The dog-phobic person is also underestimating their ability to deal with the occasional dog who actually is aggressive, by crossing the street or asking the dog's owner to control them.

Anxiety is felt in the body

One of the other problems with anxiety is that it’s not just a psychological or emotional response – it causes all sorts of changes in our bodies, too. If you think about the fight-or-flight response, which is designed to help us either fight or flee from life-or-death threats, this makes perfect sense.

Our heart rate speeds up and breathing gets faster, oxygenating the blood being pumped to all our major muscles (by the way, this explains the racing heartbeat and the feeling of breathlessness often linked to panic attacks, and the blushing that may worry people with social anxiety).

Breathing in this way also makes you feel dizzy and light-headed, while all the adrenaline pumped into your bloodstream to give you a burst of energy makes you feel hyper, edgy and even more anxious. So one of the simplest ways to help yourself feel less anxious is to work directly with the body. Use a deep breathing technique to calm yourself down; avoid caffeine (which stimulates adrenaline production); go for a walk or do more vigorous exercise to burn off that adrenaline; have a relaxing bath, do some yoga or meditate to help yourself relax.

Changing unhelpful beliefs

The other way to free yourself from anxiety is to tackle the anxiety-provoking thoughts and beliefs that are the root cause of your problem. Cognitive behaviour therapy (CBT) is proven to be the most effective way to tackle all anxiety-related problems, from social anxiety to phobias and obsessive compulsive disorder.

There is also a wealth of free material on my website to help you tackle your own problems, so do try to find something that works for you. Whether you visit a cognitive therapist like myself, or choose to deal with the problem on your own, please remember that life doesn't have to be such a struggle - with a little effort and determination you do have the power to free yourself from anxiety.

Warm wishes,

Dan