What is dissociation?

Dissociation is a self-protective mechanism in the brain that we all experience from time to time. It’s what happens when you feel overwhelmed and your brain shuts parts of itself down so you can cope with the situation. For example, when people have a car crash, they often report strange things happening, like time slowing down, floating above the scene of the accident, or not feeling any pain despite being injured. These are symptoms of dissociation, as the brain has shut down a bit to help them deal with the overwhelming and upsetting situation.

Think of dissociation like a circuit breaker being triggered. If there’s an electrical surge, a circuit breaker gets tripped to switch circuits off, so no electrical devices get damaged. That’s what happens in your brain when you dissociate.

If you experienced traumatic events as a child, your brain will have shut down to protect you. This was a healthy, ‘adaptive’ response to overwhelming feelings and sensations that your little self could not handle. But over time, dissociation becomes a habitual response, so your brain shuts down even when you experience much milder feelings, like a little anxiety.

Symptoms of dissociation

Unfortunately, dissociation causes various problems for us – we may feel spacey, empty, numb or weird in some other way (this is called ‘depersonalisation’). We might go blank, or struggle to hear what someone’s saying to us. Some people say everything looks far away, or it’s as if they are looking through a thick glass wall at the world (known as ‘derealisation’). When we dissociate we struggle to concentrate or remember important information. Not helpful if you are in a meeting, or about to take an exam.

You might experience dissociation when your anxiety is high – it’s a common symptom of panic attacks, for example. Or when you feel threatened in some way, your schemas getting triggered by a stressful event or situation that reminds you of something threatening from your past. I recently wrote a post about the ‘Detached Protector’ mode which we work with in schema therapy – this is a dissociative mode.

The good news is that dissociation can be treated – I have helped many people with dissociative problems using schema therapy. If you would like some help with your dissociation, call me on 07766 704210, email dan@danroberts.com or use the Contact form to get in touch.

Warm wishes,

Dan

How to look after your vulnerable child

One of the most important ideas in schema therapy is that we all have different 'modes' – aspects of our personality that get triggered in different situations. For example, many of us have a Demanding Parent mode, which is the part of us that pushes us hard to achieve and be successful. Because this mode pushes us too hard, it can lead to stress, exhaustion or burnout, because our drive to achieve exceeds our internal resources and so we struggle to cope with the relentless demands. 

Another part – the most important one in schema therapy – is the Vulnerable Child mode. We call this Little Dave, or Sue, or Steven, and so on (mine is called Little Dan) and it's the part that holds all of our vulnerability, anxiety, unhappiness, loneliness, feelings of rejection or being bullied, depending on our experiences as a child. For example, if your parents were harshly critical of you throughout your childhood, this part will feel defective and incompetent – as if nothing you ever do is good enough. If one of your parents died or left the family when you were young, your Vulnerable Child will feel abandoned and, as an adult, you will be hypersensitive to being left or rejected by those you love. 

In schema therapy, we work hard to look after this part of you – to help him or her feel protected, safe, cared for. In fact, we try to meet those core needs that were not met when you were a child. So if your parents were flaky or untrustworthy, as your therapist I would work very hard to be a solid, dependable, trustworthy person for you. If one or both of your parents was cold and unloving, I would try to be extra-warm, friendly and kind. In this way (as well as using all of the schema therapy techniques, especially imagery) we would, over time, heal your Vulnerable Child – and help you feel calmer, stronger, more confident and secure. It's quite magical to watch this transformation take place – even with the deepest, most sensitive wounds.

Caring for yourself

Of course, you don't need schema therapy to start this healing process yourself. Learning to be kinder and more compassionate to yourself is a good start – take a course in mindfulness, visit a Buddhist centre near you or check out Dr Kristin Neff's website, where there are many free resources on self-compassion training. Yoga is another great way to heal your mind and body, as is reading one of the many wonderful self-help books available – try Loving-Kindness: The Revolutionary Art of Happiness, by Sharon Salzberg; or Get Your Life Back: The Most Effective Therapies for a Better You, by Fiona Kennedy and David Pearson, for starters. If you are using alcohol, drugs or food to deal with painful emotions, you may need help to tackle your compulsive behaviour. Visit my Resources page to find a whole range of useful organisations working in this area.

It is my strong belief that, whatever has happened to us in our past, it is never too difficult or too late to change. You may not be able to do this on your own – if so, seek help from me, another schema therapist or any psychotherapist sufficiently well trained and competent to tackle deep-rooted problems. Ultimately, healing yourself begins with a decision – that you are worthy of love and happiness; that you do not want to spend the rest of your life suffering because of painful experiences that were not your choice, not your fault in any way. We only have one life, so it's up to all of us to make the most of it, however hard it has been up to now.

If you would like some help, call me on 07766 704210, email dan@danroberts.com or use the contact form to get in touch.

Warm wishes,

Dan 

 

 

Self-Care for the Highly Sensitive Person

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I recently wrote a post about Elaine Aron's wonderful book, The Highly Sensitive Person: How to Thrive When the World Overwhelms You. I also admitted that it was a particular eye-opener for me because I realised she is writing about me – I am a highly sensitive person and proud of it. And probably at least 50% of my clients are HSPs too, so this concept has helped me immensely, both personally and professionally.

As a follow-up, here are three of the things I have realised about how we highly sensitive folk need to take care of ourselves day to day:

  • We need time to process. Sometimes, in my downtime between seeing clients, writing up session notes, and all the many other things I do as part of my (wonderful) job as a therapist, I notice that I am compulsively surfing the Web. Having recently given up social media (here's another post about that), I realised that looking at The Guardian's website and depressing myself with the latest scary thing happening in the world, or just reading football-related nonsense, was my new digital addiction. I also realised that it made me feel, well, just bad. HSPs need time to process stuff, because we are so attuned to every detail of what is happening that it's easy to get flooded (what Aron calls being over-aroused). So more mindfulness for me, less scary news and screen time.

  • Slow is (generally) good. Linked to the first point, because being an HSP means that our central nervous system is unusually sensitive (which is neither good nor bad, just a largely genetic trait), we get easily overwhelmed by things. Bright lights, loud noises, strong smells, traffic, too much information, too many strong emotions, big crowds, strangers, public speaking, aggressive or loud people... the list is a long one but will be unique to you – some of these may be triggers for you, some not, but you will definitely have your triggers. Personally, I like to talk and think about things slowly. I am more into deep thinking and powerful, one-to-one conversations than social chit-chat. Slow is good for me, even if I don't always remember that.

  • Alone time helps us recharge. As Elaine Aron points out, not all HSPs are introverts. You can be a highly sensitive extrovert, but common sense says that most HSPs will prefer small groups, close friends or time alone. I am certainly one of those – although I love seeing clients all day, or even teaching large groups, I do find some alone time in the day invaluable. It helps me rest and recharge, as well as giving time for processing everything I have thought, seen and experienced that day (see point one). As with all of these points, it's important to remember that none of this is good or bad, it's just how I and probably most people reading this are wired. Learning to love and accept yourself as you are is a crucial component of schema therapy, so recognise your need to be alone sometimes and carve out that time for yourself.

And if you would like some help, call me on 07766 704210, email dan@danroberts.com or use the Contact form to get in touch.

Warm wishes,

Dan 

 

What is the Detached Protector mode in schema therapy?

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One of the most common 'modes' in schema therapy is the Detached Protector, which tries to protect us by suppressing our painful emotions. When we are in this mode we are very much in our heads, being overly rational and cut off from our feelings. I guess if I were to think of the living embodiment of this mode, it would be Sheldon in The Big Bang Theory – someone who lives completely in his head, who doesn't feel much or understand other people's emotions at all.

So this is a part of us that gets activated when, say, we are upset and fear becoming overwhelmed. Our Detached Protector (unconsciously) kicks in and we change focus from the painful feelings to change the subject, tell a tangential story, or rationalise the way we feel until we're not feeling it any more. Very commonly when my clients are in this mode they will be talking about an upsetting experience without actually feeling that upset in any way.

This part of us almost always develops in childhood, when we may have learned to shut down to cope with overwhelming emotions. A good metaphor for this process is the way a circuit breaker gets triggered when there's a power surge – it shuts the system down so nothing gets damaged. So something in your brain gets triggered and switches off its emotional circuitry, to protect you from unbearably intense emotion that you are too young and undeveloped to deal with (managing big emotions and self-soothing when they are upset is not something that young children are able to do).

We also call this process 'dissociation', which basically means disconnection or detachment from our inner experience or the world around us. The younger you are, the harder it is to regulate your emotions, so if you are scared because someone is hurting or threatening you, the only way to protect yourself is to trigger this circuit breaker in your brain.

From helpful to habitual

This shutting down was both helpful and necessary when you were little, but over time it became a habit and led to an increasing number of problems. For example, imagine that Stephen comes to therapy because his wife is threatening to leave if he doesn't stop going quiet and withdrawn whenever they have a problem in their marriage. When Stephen comes to see me, he tells me he's deeply worried about losing his wife, who he loves very much. But when they have conflict, he just 'clams up' and feels empty and numb inside.

This is Stephen's Detached Protector kicking in – probably because conflict situations were scary or threatening for him as a child, so he learned this self-protective behaviour. In schema therapy, a big part of the work would be helping him learn to feel and express his emotions a bit more – also to communicate with his wife when things got bumpy. These simple changes could make a profound difference to Stephen's day-to-day life and even save his marriage!

It's important to repeat that this part of you is a protector mode – it's not bad or mean in any way. It's just that, like Stephen's experience, what starts out as helpful and even life-saving becomes a hindrance over time. So with Stephen, it would be important to teach him healthier way of managing his feelings – talking about them to me, his wife or a friend; using deep breathing, helpful ways of thinking or mindfulness techniques to feel calmer and more relaxed, even when conflict flared up. Over time, bit by incremental bit, this could be transformative for him – and, if you have a Detached Protector, for you too.

If you would like to know more about schema therapy, call me on 07766 704210, email dan@danroberts.com or use the Contact page to get in touch.

Warm wishes,

Dan

 

 

How to deal with difficult emotions

If you want to understand how we are meant to feel emotions, look at a small child. When kids feel their emotions they really feel them! If they are angry, they will shout and scream and have a tantrum. If they are sad, they will cry. If they're scared, they will run away, or hide behind their mum's legs until the threat has passed. Now, I'm not saying that as adults we should indulge ourselves in tantrums, but neither should we repress or swallow our feelings.

Sadly, as we grow older we tend to stiffen up. We learn that (for men) it's not OK to cry when we are sad, or to tell our friends if we're going through a rough time. Or (for women) that being angry or assertive is unacceptable. We start to feel bad for feeling bad. We learn to hide our feelings, sometimes even from ourselves. Or we use a substance (alcohol/weed/cocaine/food/cigarettes) or an activity (gambling/hours spent on Facebook/gaming/shopping/sex) to numb or avoid uncomfortable feelings like anxiety, sadness, loneliness, anger or hurt. And the message we are giving ourselves is that emotions are somehow bad, wrong or even threatening.

Let's go back to the kids. Watch a child getting angry: they feel the anger, intensely. Then they release it, verbally and physically. Then they seek a trusted person to soothe and comfort them. And then... the anger is gone. They see a butterfly and chase after it, utterly delighted and distracted, with no trace of the anger left in their body or mind. This is how we are supposed to feel, process and seek solace when we experience strong emotion. I have started summing it up for my schema therapy clients with a simple formula:

1. Feel it. If you're sad, be sad. If you are angry, let yourself be angry. It's just an emotion and can't do you any harm – in fact, the only harm we can do is if we try to avoid the emotion (leading to problems like addiction or anxiety disorders such as OCD).

2. Release it. If you are sad, and alone, have a cry. If you're angry, write a (never-to-be-sent) letter to the person you're angry with, then burn or tear it into tiny pieces. Vent the emotion and let it go.

3. Get soothed (by yourself or a trusted person). Just as children need soothing when they are upset, so do adults – we're just not very good at doing it for ourselves or seeking it from those we love and trust.

Learning to detach

One of the unconscious ways we learn to suppress or avoid our feelings is by detaching, which involves a psychological process called 'dissociation'. This is something we all do, to a greater or lesser extent, but will have learned to do a great deal if we suffered trauma, abuse or neglect as a child. Dissociation is an unconscious process in which the brain shuts down to protect us from overwhelming stress. It's a bit like a fuse blowing on a circuit board when there is a power surge, to stop electrical devices getting fried.

If we dissociate a lot as a child, it becomes an automatic process that we over-use, shutting down when we feel any kind of difficult emotion. This leads to us developing a 'mode' called the Detached Protector – one of the most common modes in my clients. We may feel numb, empty or spacey when this mode is triggered. We might also feel disconnected from other people, even experiencing strange sensations such as feeling far away, seeing the other person as very small, or feeling like there is a glass wall between us and the world. These are all common symptoms of dissociation.

None of this is bad or wrong – it's just what we learn to do to protect ourselves from overwhelming pain or stress. Part of my job is helping people unlearn this unhelpful coping strategy, feel their emotions as described above, and learn to build up their 'emotional muscles', so they feel stronger, more resilient, and can live a rich and fulfilling life. After all, emotions – the full range, both those we like and the ones we would rather not feel – are what make us human.

If you would like some help with your uncomfortable emotions, call me on 07766 704210, email dan@danroberts.com or use the contact form to get in touch.

Warm wishes,

Dan

 

How to deal with suicidal thoughts

If you are having suicidal thoughts, you are not alone. Sadly, thinking about harming yourself is extremely common. And tragically, many people in the UK and around the world take that one step further and either attempt to hurt themselves or succeed in taking their life. In the UK, suicide is the leading cause of death among men under 50 – more than heart disease, cancer or road accidents.

But it doesn't have to be this way. I have worked with hundreds of people who had thoughts of harming themselves – and helped them see that suicide is not the answer. It is devastating for those left behind. It might seem like the only solution, but it never is. And suicidal thoughts come and go, so if we can help people through the worst – often quite short – period of time, those thoughts and impulses will naturally recede.  

Helping with depression

One of the most important messages I give people is that thoughts of suicide are completely natural, especially when we are feeling depressed. That's because our thinking becomes very negative and it's hard to see anything good in life, or to believe that things will ever get better. Depression is also really tough to deal with day to day, so ending your life seems like a way to stop the pain. But we can now treat depression extremely effectively with CBT, so once your mood lifts you will no longer feel that way. 

It's heartbreaking for me every time I hear of someone taking their own life, because I always think, It didn't have to be that way. Someone could have helped them and they would still be here today.

Mental-health professionals know that some psychological problems bring greater risk than others. These include depression, alcohol abuse, anorexia, psychosis and schizophrenia, bipolar disorder and 'personality disorders' like Borderline Personality Disorder. So if you or someone you love is suffering from one of these problems, please do keep an eye on them. Reach out to them often and ask how they are. Also be straight and say, 'I'm worried about you, are you thinking of killing yourself?' Just asking that question could help save their life, because if the answer is yes you should contact their GP or one of the numbers below.

If you are reading this and thinking of hurting yourself, please don't. Tell someone, even if it seems like the hardest thing in the world. I promise you that help is available – and that, a year from now, you will look back and feel the deepest gratitude that you kept yourself safe and can still enjoy all of the wonderful things life has to offer.

Warm wishes,

Dan

If you are thinking of taking your own life, or know someone who might be, please call one of the numbers below:

The Samaritans – available 24 hours a day, 365 days a year on 116 123 or email jo@samaritans.org

Childline – for children and young people under 19. Call 0800 1111 – the number won't show up on your phone bill

The Silver Line – for older people. Call 0800 4 70 80 90

SANE provides confidential support for people with mental-health problems, every day of the year from 4.30pm to 10.30pm on 0300 304 7000

Campaign Against Living Miserably (CALM) – for men. Call 0800 58 58 58 – 5pm to midnight every day

Papyrus – for people under 35. Call 0800 068 41 41 – Monday to Friday 10am to 10pm, weekends 2pm to 10pm, bank holidays 2pm to 5pm. Text 07786 209697 or email pat@papyrus-uk.org

 

 

Why humans need connection

Humans are born wired for connection – it's in our DNA, as strong a need as food, water and warmth. And if you look at a newborn baby, that makes sense. Unless babies successfully attach to their mother, they won't be able to survive – human infants are born completely helpless, so we are entirely reliant on our caregivers. A loving, secure relationship is literally a matter of life and death for babies.

So in our brains is an 'attachment system', which gives us a magnetic attraction to others – (usually) first mum, then dad, siblings, grandparents, aunts and uncles, school friends, teachers, adult friends, colleagues, mentors and later romantic partners and our own family, when the whole cycle starts over again. Jeffrey Young, the founder of schema therapy, understood this need for attachment – that's why it is one of the core developmental needs he identified in all children (along with the need for safety and protection; to be able to express our feelings and emotions; spontaneity and play; and boundaries/being taught right from wrong).

Another psychotherapy pioneer to understand this fundamental need was psychoanalyst John Bowlby, often called the 'father' of attachment theory. Bowlby realised that all children (and adults) need a secure attachment to their caregivers, especially mum. If we are lucky enough to develop this secure attachment in infancy, this 'attachment style' will remain constant throughout our lifetime and help us form strong, stable, loving relationships with friends, romantic partners and then our own children.

Strengthening your connections

Most of the people I see for schema therapy were not so lucky. For various reasons, their attachments were not secure as children, so they have all sorts of problems in relationships now. Perhaps they struggle to commit, or dive in too quickly and deeply (especially if they are a Highly Sensitive Person - read about them here). They may avoid relationships altogether, because they are just too painful. But, as I always tell my clients, although these patterns are firmly established in our brains, they are not set or fixed in any way. Our brains are always changing, throughout our lifetime (because of neuroplasticity). This remarkable discovery means that we can learn to attach more securely and so learn to love, to trust, to allow others into our lives.

This is one of the most moving and beautiful aspects of therapy – seeing people learn to deepen and strengthen their connections, first with me, then family, friends and later a romantic partner, even if this seems like an Everest-sized obstacle at the beginning of our work! However daunting it seems, remember that you are never too old and it is never too late to let love blossom. We are born ready to love – it's just the painful experiences we have when young that throw us off the path toward fulfilling relationships. All you have to do – with help, guidance and support – is step back on to the path... 

If you would like some help with strengthening your connections, call me on 07766 704210, email dan@danroberts.com or visit my Contact page to get in touch.

Warm wishes,

Dan

Be a force for good in the world

This post is a bit different from my usual writing on this blog. As a therapist, I am passionate about helping people – those I see in my office, the ones I can reach through my writing, and those who are suffering all over the world. For me, promoting kindness,  compassion and good mental health and believing in social justice go hand in hand. And it currently seems that many of our leaders and corporations, rather than striving to make the world a better place, are doing a great deal of harm. 

Reading the news on a daily basis, it's easy to feel overwhelmed by all the negative things that are happening around the world. In the UK, we have a government that has done terrible damage to beloved and life-saving institutions like the NHS; and years of austerity have done real and lasting harm to the mental and physical health of millions of – mostly poor – families in the UK. As mental health problems increase at worrying speed among our young people, it's not hard to see the impact of these policies on people's lives.

The arc of the moral universe is long, but it bends toward justice.
— Martin Luther King

In the US, we have a President who attacks the very foundations of democracy on a daily basis, while promoting an agenda which encourages the worst elements of humanity at home and abroad. If you, like me, are a liberal, what should we do? It's tempting to give up and retreat, to focus on the small daily pleasures that life brings and try to ignore the news, hoping it all eventually goes away. But, as someone who believes passionately in social justice; whose life is dedicated to bringing more kindness and compassion into the world; who is deeply proud of living in the wonderful multiracial and multicultural melting pot that is London, I think we have to do all we can to stand up for the forces of light in the world.

What you can do

As the descendant of Russian Jews, who emigrated to Britain in 1905 to escape the Pogroms; whose grandparents worked for a Jewish charity helping immigrants fleeing Hitler in the 1930s, I know all too well where nasty, dehumanising ideologies can lead. And I think we all need to do everything we can to stop them. 

So instead of feeling overwhelmed and helpless, here are three things you can do today:

  • Be a digital activist. Sign petitions (they do work, whatever people say), write to your politicians, post on Facebook walls and tweet to corporations and others who are causing harm. 
  • Boycott companies which are behaving unethically (here is a list of the most and least ethical companies in the world). Write to them and tell them why you are no longer a customer – this is the most effective way to get big companies to change, because losing money and negative PR are the most important influences on them to behave more ethically.
  • Support campaigning organisations like Greenpeace, WWF, Amnesty International USA, the American Civil Liberties Union (ACLU), Earthjustice, Hope Not Hate – they are fighting to protect the environment, human and civil rights in the courts, which is a powerful strategy to effect positive change. 

And don't succumb to hatred or bitterness – another Martin Luther King quote comes to mind: 'Darkness cannot drive out darkness; only light can do that. Hate cannot drive out hate; only love can do that.'

Warm wishes,

Dan

How chronic pain and illness affect your mood

As I sit writing this, I am in a moderate amount of pain. Like millions of people around the world, I suffer from chronic musculoskeletal (back and hip) problems, so most days come with either a small or large dose of pain, depending on how well I am looking after myself, how stressed I am, how much sitting I do that day, and various other factors.

Having been in some degree of daily pain for almost two years now, I have learned a few things about the relationship between physical pain and mental suffering:

  • It's important to distinguish between 'primary' and 'secondary' pain. I learned this from Vidyamala Burch, founder of the excellent Breathworks. This organisation provides the Mindfulness-Based Pain Management programme, which has a strong research base behind it and helps many people in the UK and beyond deal with chronic pain and illness.
  • Burch also co-wrote Mindfulness for Health: A Practical Guide to Relieving Pain, Reducing Stress and Restoring Wellbeing with Danny Penman. In this superb book the authors explain that primary pain is the actual raw data caused by, say, a gash in your leg. Intriguingly, the majority of the pain you end up experiencing is secondary – the pain created by your brain as it amplifies that raw data, depending on the way you think about and respond to your primary pain.
  • This only became clear to me recently when I visited my osteopath during a bad patch physically, feeling down and hopeless about resolving my problems. He reminded me that the pain was significantly better now than when I first came to see him; and that it was crucial to remain as positive as possible, because my negative thoughts ('I will never get over this'; 'Nothing will help'; 'I can't stand the pain any more') were undoubtedly making the pain worse (this is essentially what the Buddha taught – that human life inevitably involves pain, but we create suffering by our response to that pain. But that's a topic for another day).

Managing the pain

I think it's important to note here just how hard it is to maintain a positive, optimistic mood in the face of chronic pain or illness. As anyone with a long-term condition knows, it grinds you down, especially when it flares up or your symptoms get worse for whatever reason. Please don't think I underestimate the impact of physical ailments on your mood – it is a struggle and gets everyone down from time to time, as well as causing stress and worry/anxiety about the future.

I couldn't understand that vicious cycle any better. But once you understand the relationship between pain sensations in the body and the way that your brain either amplifies or minimises those sensations, it seems crucial to me that you do all you can to use your brain/mind to help your body.

 When I first hurt my back and was really struggling, Vidyamala Burch's guided meditations really helped pull me through. Here is a great one on being more compassionate to yourself, available for free, if you would like to try it. And if you are dealing with chronic pain or illness, my thoughts and well wishes go out to you – I hope you get the medical help you need and manage to overcome your problem soon.

If you would like some help with the psychological aspects of your condition, call me on 07766 704210, email dan@danroberts.com or use my Contact form to get in touch.

Warm wishes,

Dan

Should you quit social media?

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Having dabbled in Twitter and been on and off Facebook over the years, I recently decided to quit social media altogether. This was partly a reaction to the Cambridge Analytica scandal and my discomfort at the potential use of my data to enable calamitous, world-damaging events like Brexit and Trump's election. But I have become increasingly worried about the effect of social and other digital media on my brain.

I noticed that my attention span was shrinking – I found it hard to focus deeply on any one subject and was often zipping off to some website or other, interrupting my reading or writing. I also felt addicted to quick bursts of digital stimulation, even if what I was reading – football gossip, the latest gloomy event to dominate news cycles – either made me feel nothing much or downright bad.

As a long-time mindfulness practitioner, all of this manic distractibility felt especially wrong to me. Haven't I spent the last eight years training my brain to be quiet and still, to focus? Is that not the whole point of mindfulness practice? So what was I doing logging into Facebook 20 times a day, itchy for a little dopamine hit when someone liked my post? It made no sense at all and felt jarring to the person I was trying to become.

The final straw for me was reading Cal Newport's brilliant Deep Work: Rules for Focused Success in a Distracted World. He makes a powerful argument that the way we live and work and think in the 21st century is damaging our ability to produce 'deep work' – the kind of creative output that leads to a Van Gogh painting, or Ian McEwan novel. Now, I know I'm no Van Gogh, but I do want to write books, to think deeply about my clients and their problems, to understand complex psychological issues and learn the latest developments in CBT, schema therapy and other approaches that can help the people I work with.   

Going cold turkey

Newport takes quite an extreme approach to maintaining his focus. He doesn't surf the web, has never used Facebook or any other form of social media, gets his news from an actual newspaper, and only bought a smartphone when his pregnant wife made him buy a phone that actually worked! He admits that it's a bit extreme, but he does produce a huge amount of work – including his wonderful book – and only does a 9-5, five days a week. (If you still need convincing, here is his TED Talk, explaining why he thinks we would all be better off without social media).

Only you can decide whether your social/digital media consumption is hurting your brain, but I can testify to the fact that I feel much better without daily hits of Facebook. I do still overuse The Guardian online, but I'm working on that. I am on LinkedIn, but that's just for work and I rarely look at it. And I feel much more focused, less distracted, more mindful, even... I strongly recommend giving it a try, even if only for a week or two. Digital detoxes are also a good idea – try having at least one screen-free day a week.

And if you want my help with this or any other problem, call me on 07766 704210, email dan@danroberts.com or use the contact form to get in touch.

Warm wishes,

Dan

 

 

 

 

Are you a Highly Sensitive Person?

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I have been reading a self-help book recently by Elaine N Aron – an American clinical psychologist who has spent her career researching, writing about and providing therapy to Highly Sensitive Persons (HSPs). Aron discovered this group and set about testing her theory that some people are more sensitive than most – she believes HSPs make up about 20 per cent of the population. Her book, The Highly Sensitive Person: How to Thrive When the World Overwhelms You, is written for HSPs like herself, as she is an unusually sensitive individual too. 

I must admit that this book has had a huge impact on me. Not only does it describe at least 90 per cent of the people I work with, but it also describes me with eye-opening accuracy. HSPs, according to Aron, have an unusually sensitive nervous system. This means that they pick up on far more of the information in their environments than less-sensitive people. They are affected by bright lights, loud noises, crowds and strong smells. If there is tension in a room, they will pick it up and find it uncomfortable. They will intuit which people in a group are friends and who dislikes each other. They are like tuning forks for subtle interpersonal vibes.

Aron is quick to point out that being an HSP does not make us superior to our less-sensitive friends, family members or colleagues. This sensitivity is a trait – largely genetic but also affected by our life experiences – that is neutral. In some ways, it is a real advantage – I always tell my clients that I could not be a schema therapist without a high level of sensitivity. Being this sensitive makes me, and all other HSPs, more thoughtful, empathic, attuned to other people and their needs, as well as a whole host of other good things.

Sensitivity is no bad thing

But perhaps the most important point that Aron makes – and one I really want you to take on board – is that being sensitive is in no way a bad thing. I don't know about you, but all my life people have told me I should be less sensitive. 'It's just a joke – stop taking things so seriously!' Or, 'Why do you always make such a big deal about things? Just man up and toughen up, for God's sake.' Don't be so shy/introverted; be the life and soul, speak louder, be more of a 'character'. 

For men especially, sensitivity is often seen as a weakness, or something to be ashamed of. Many HSPs get bullied at school, for precisely this reason. And extra-sensitive women are often told they are crazy, or over-emotional, because they feel things deeply and cannot just lighten up, or get a grip, or let it go. So if this describes you, please understand that there is nothing wrong with you – and certainly nothing to be ashamed of. You are just genetically, temperamentally, a bit different from most other people. This probably means that you have been very much affected by difficulties in your childhood, or family of origin.

You may have an anxiety disorder, or get depressed. You may even have personality problems, or struggle with addiction. All of these things need help, from a professional like me or one of my colleagues, who are trained to help sensitive people (and less-sensitive ones, of course) become happier and healthier. I would also strongly recommend reading this book. And if it describes you, give it to your partner, friends and family, so they can better understand you and why you behave as you do.

If you would like some help, call me on 07766 704210, email dan@danroberts.com or use the contact form to get in touch.

Warm wishes,

Dan

 

 

 

How self-criticism affects your mental health

It's common sense that being overly harsh or self-critical in your thinking will have a negative impact on your mood, confidence and overall wellbeing. But I think it's important to understand exactly why this is the case. Because of the miracle of magnetic resonance imaging (MRI) scans, we now have an intimate knowledge of how the brain operates under stress. We can see which parts of the brain 'light up' when we are feeling stressed or attacked – this is known as the 'threat system', a powerful self-protective network in the brain that detects and responds to any kind of danger or threat.

When you engage in self-critical thinking, calling yourself an idiot, or saying you are stupid or useless – especially if your internal dialogue has an harsh or hostile tone – MRI scans show the same threat system lights up in your brain as if someone else was shouting at or scolding you. It's no surprise that this kind of thinking is closely linked with depression, problems with anger and anxiety, as well as a lack of confidence or low self-esteem.

When you speak to yourself harshly, it's as if there is a bully in your head judging everything you say or do and putting you down at every turn. Not helpful. If you do tend to engage in self-critical thinking, try the following exercise to start being kinder to yourself:

The best friend test

When you make a mistake, have a setback or feel like you have failed at something important to you, you might find yourself slipping into a well-worn groove of negative, self-critical thinking: 'I am such a loser – why do I always screw things up?', or 'God, that was pathetic, I really am a failure.'

Unsurprisingly, these words will hurt and you will find your mood dipping and confidence ebbing away.

Instead, try to start noticing when you talk to yourself like that and take a step back. Imagine your best friend had just made the same mistake, had a setback or failed at something they valued. What would you say to them? Would you be harsh, mocking or critical? Probably not. I'm guessing you would try to be supportive, encouraging and help them see that it wasn't the end of the world.

You might say things like, 'Don't worry, it seems bad right now but you will feel better about it soon,' or 'Everybody makes mistakes sometimes – that doesn't make you stupid or a bad person, just human.'

Now try and start talking to yourself in the same way. If you notice that self-critical thinking kicking in, use the Best Friend Test to be a bit more kind and compassionate to yourself. Over time, it will help you feel calmer, stronger and more at peace. After all, life is hard enough, so why make it harder by being unkind to yourself?

If you would like to book a session, call me on 07766 704210, email dan@danroberts.com or use the contact form to get in touch.

Warm wishes,

Dan

What is the Healthy Adult mode in schema therapy?

One of the key ideas in schema therapy is that we all have different 'modes', or parts of our personality, which are more or less helpful for us in our lives. One of the most important of these modes is the Healthy Adult, which is the part of you that does all the important day-to-day stuff like going to work, being a caring parent and partner, paying the bills, going to the gym, not drinking too much, and so on. 

So the Healthy Adult does all the important, healthy stuff that you often take for granted, but without which life would quickly grind to a halt. This part is also very protective, again in terms of the outside world, being assertive when you need to stand up to an aggressive boss, say, or dealing with the teenage neighbour who loves blasting their favourite house music at 2am.

Silencing your inner critic

The Healthy Adult also protects you from yourself. In schema therapy, we also work with two 'maladaptive parent' modes, the Demanding Parent and Punitive Parent. The first drives you way too hard, often leading to stress or burnout – nothing is ever good enough. And the second is your inner critic, telling you that you are stupid, or fat, or useless. Both modes need to be disempowered, told to shut up and leave you alone. It's the Healthy Adult's job to do that. 

Finally, and perhaps most importantly, the Healthy Adult looks after the most vulnerable, wounded part of you, the Vulnerable Child. This part holds a lot of your most difficult schemas, so is the mode that is triggered when you feel anxious, upset, threatened or ashamed. All of our work in schema therapy is about healing this part of you, at first with my help but later through your Healthy Adult.

Working together, we will build this healthy, protective part of you like an inner muscle, until it is strong enough to calm you down when you're upset, or help you through a challenging job interview or parent's evening at school. You will feel yourself getting stronger and stronger; making increasingly healthy choices in your life; letting go of self-soothing strategies like excessive drinking or spending... And you will find yourself becoming more like the person you always wanted to be, but never knew how.

If you would like to find out more about how schema therapy can help you, call me on 07766 704210 or email dan@danroberts.com

Warm wishes,

Dan

 

Are you an orchid or a dandelion?

One of the key ideas I always share with my clients is that we all have a certain temperament, which we are born with and which has a profound impact on the way that life experiences, good or bad, affect us. Many of my clients have a sensitive, emotional temperament, which means that they are much more affected by problems in the family than someone with a robust, more intellectual temperament. It's important to emphasise that having a certain kind of temperament is neither good nor bad – it's just like being born with brown or blonde hair, blue or green eyes, not your choice or fault in any way but simply how you arrived on this planet.

I also tell my clients that I have a sensitive, emotional temperament too. This can make life difficult at times, as I am affected deeply by negative experiences and my childhood was pretty bumpy, to say the least. But it also bestows on me particular talents and gifts – I could not be a therapist without this kind of temperament. After all, you wouldn't want a therapist who was insensitive, unempathic or unkind! 

Dandelion children

Psychologists have, in recent years, been investigating the theory that we are all either orchids or dandelions. This is based on the Swedish idea that 'dandelion children' are pretty robust and do well in any environment, even if the parenting and family dynamic are less than perfect. US psychologists Bruce Ellis and W. Thomas Boyce extended this idea to include 'orchid children', who were especially sensitive and so needed just the right conditions to thrive. In practice, that means loving, nurturing parents; a relatively calm and stable family environment; and no traumatic experiences during childhood.

If orchids have a difficult family dynamic, they will struggle – developing a number of schemas which will affect them throughout their life and very likely experience depression or anxiety, among other problems, when these schemas are triggered by stressful events. But, if these sensitive children are well-nurtured, they will bloom into beautiful young people and later adults – just like the orchids above.

If you are a dandelion, you may not need my help. But if you're an orchid whose childhood was not what you needed, life may be a struggle. If you would like some help, call me on 07766 704210 or email dan@danroberts.com

Warm wishes,

Dan

 

Schema therapy or CBT – which is right for you?

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If you are struggling with psychological problems, you may be thinking about having some therapy – but which kind of therapy should you choose? I offer both cognitive behaviour therapy (CBT) and schema therapy – two of the most effective forms of 'talking therapy' currently available – at my North London practice. Here is a guide to which therapy is the best fit for different kinds of problems...

CBT is widely recognised to be the most effective, evidence-based form of therapy ever created. Founded by Dr Aaron Beck in the 1960s (originally as just 'cognitive therapy' – the B was added later on), CBT has been proven to be effective at treating depression, anxiety disorders such as OCD or health anxiety, panic attacks and agoraphobia, eating disorders, anger management problems, addiction... the list goes on.

If your problem is relatively short-term (for example, one episode of depression rather than many); if you are functioning fairly well in most aspects of your life, but struggling with a specific problem like anxiety or depression; if you would prefer a short-term treatment; and if, perhaps, you have had CBT before and found it helpful, or have been recommended CBT by your GP or another medical professional, then CBT is probably the right choice for you. It is always possible to have CBT to reduce upsetting symptoms, such as panic attacks, and then move on to schema therapy afterwards to address more deep-rooted problems.

When schema therapy is the best option

In general, it's best to opt for schema therapy (ST) if your problems are longstanding – for example, if you have been struggling with recurrent episodes of depression for much of your life. Problems related to a difficult childhood, to extremely critical parents, say, or if you experienced abuse, neglect or traumatic incidents as a child, are best treated with schema therapy. CBT will be helpful up to a point, but schema therapy is designed to heal painful/unhelpful ways of thinking, feeling and behaving at a deep level – otherwise you may find problems coming back after therapy when you experience a period of stress, say, or a relationship breakup.

Schema therapy was developed by Dr Jeffrey Young in the 1990s to treat people with personality problems – especially Borderline Personality Disorder, which can have a profound effect on someone's life and was poorly treated before approaches like schema therapy and dialectical behaviour therapy (DBT) came along. Because it's intended to help with deep-rooted problems, schema therapy is a slower, longer-term approach than CBT. Generally, I tell my clients that 20 sessions are the minimum – and therapy can last for a year or more for really hard-to-treat problems. It's important to note that schema therapy is not just for personality problems – it is now used to treat all of the difficulties people seek therapy for.

In terms of how it feels to have ST versus CBT,  I would say that schema therapy is a warmer, more compassionate, more nurturing approach than CBT. It's much more focused on the relationship between therapist and client, rather than specific techniques to change thinking or behaviour, which form the bulk of treatment in CBT. But of course because schema therapy is just a newer form of cognitive therapy, all of the CBT techniques are still available, if I think they will be helpful for you.

I hope that helps – but if you would like to know more about which form of therapy might be best for you, call me on 07766 704210 or email dan@danroberts.com

Warm wishes,

Dan 

 

Can anxiety lead to depression?

Although it's common for people to suffer from mixed anxiety and depression, and both problems have negative thinking at their root, there are key differences between the two. When we are anxious, our thinking will be overwhelming threat-related – we worry about danger of some kind, or bad things happening to us or those we love. When we are depressed, our thinking commonly focuses on themes of loss, regrets about the past, being stuck or trapped, or feeling hopeless about the future. So in cognitive therapy we treat depression and anxiety in different ways, based on different theoretical models and using slightly different techniques.

But something I often see is that people with an anxiety 'disorder', such as health or social anxiety, over time become depressed as well. Although this can be doubly frustrating and upsetting for the person, who now has depression to deal with on top of their anxiety problem, if you think about the effect that chronic anxiety problems have on us, it's not surprising. Let's take health anxiety as an example: when someone's worry and anxiety focus on their health, they will be hypersensitive to any physical symptoms, however minor, such as headaches or variations in their heartbeat. For the health-anxious person these – usually benign – symptoms mean they have a brain tumour or life-threatening heart condition.

Anxiety can be exhausting

Clearly, this is extremely worrying and upsetting for them, as they may spend most of their waking hours feeling highly anxious about getting a serious illness. Over time, this will wear them down – they may be sleeping badly, so will become physically and mentally drained and exhausted; they might feel emotionally wrung out from all the worrying; they may also feel stuck and hopeless about getting anyone to believe them, because doctors keep telling them there is nothing wrong, even though they are 100% sure there is. Put all this together and, over time, this poor health-anxious person may also become depressed.

In my experience though, if you help them overcome their health anxiety, the depression naturally lifts too. So it's very important that they get the right kind of help and support – if not, they might stay anxious and low for many years. I strongly believe that no-one should suffer from anxiety or depression in silence, because both problems are treatable with cognitive behaviour therapy (CBT). So please do get some help from me or another cognitive therapist soon.

If you would like to book a session, email dan@danroberts.com

Warm wishes,

Dan

Why do we worry?

In some ways, the answer to this question could be: because we are human. Our powerful brains are problem-solving machines, always working away at the difficulties we face and trying to help us resolve them. This is a good thing, helping us find our path through life's many challenges; making us protective, thoughtful parents; solving problems at work, with our finances or in our love life. When thinking about why we worry, this is an important place to start – worry, per se, is not a bad thing.

What is less helpful is when we worry to excess, spending hours a day fretting about every aspect of our life. Or when that worry comes at 3am, keeping us from precious sleep while we chew over problems best left till the morning. And worry is especially unhelpful when it makes daily life unbearable, because we are so caught up in anxious, obsessional thinking about everything we do or say – and particularly about the myriad ways in which things that are important to us might go wrong.

In cognitive therapy, this is known as 'catastrophising' – when we constantly jump to the worst-case scenario, assuming that things will always turn out badly. Catastrophising is an unhelpful thinking style associated with every kind of anxiety problem (which makes sense when you understand the anxiety formula, explained in this post). It is also a feature of depression, as depressive thinking is overwhelmingly negative, so we always assume things will go badly for us.

Chronic worry is particularly associated with generalised anxiety disorder, which can make life very upsetting and difficult for people – but is treatable with cognitive therapy. One of the first things I do with my worried clients is to explain the difference between productive and unproductive worry. Unproductive worry is when we 'ruminate' about our problems, anxious thoughts going round and round in our head without finding any helpful answers or solutions. Productive worry is when we engage in focused problem-solving that leads to constructive solutions.

If you have a problem with worry, try this simple CBT technique today:

Take a worry break

If you are engaging in unproductive worry – for example lying awake fretting about your daughter's disappointing GCSE results at 3am – tell yourself firmly that you will take a 'worry break' the next day when you can think about this problem as much as you want.

Then get up (briefly – you are already awake!), find a half-hour slot in the following day and write Worry Break in your diary. Then follow these two simple rules:

1) In order to reward yourself with this break, you're not allowed to worry about your daughter until then. If your mind wanders to that subject (as it probably will), tell yourself firmly 'I am not going to think about this now, because I will focus on the problem tomorrow.'

2) During the worry break, your worrying must be productive. That means you have to come up with some solutions to your daughter's problems, not just fret about them. If you are struggling to come up with solutions, try talking it over with a trusted friend or family member – it's often easier for other people to think rationally about our problems, as they are not so emotionally charged for them.

If you stick to this regularly, you will find your upsetting, unproductive worrying reduces significantly. And if you would like to book a session with me, email dan@danroberts.com

Warm wishes,

Dan

Should you take antidepressants?

If you are struggling with anxiety, or have been depressed for a few weeks and visit your GP, they are likely to prescribe antidepressants. But should you take them? And is medication really what you need? In a large number of cases, I think not. Before I explain why, let me be really clear – if you are severely depressed, your mood may be so low that some of the alternatives I'm about to suggest just won't work. In that case, you may need a course of antidepressants to lift your mood enough for talking therapy, for example, to work.

If you have bipolar disorder, you will probably need to take a combination of different medications, such as a mood stabiliser and possibly antidepressants. And, crucially, if you are currently taking antidepressants you should never stop taking them without consulting your psychiatrist or GP. This can be extremely risky, so please don't do it.

That said, I do worry that many hard-pressed GPs now dole out antidepressants far too easily. I don't blame them for this – they have so little time with patients now that they are often forced into the simple solution that medication represents. They may also want to refer a patient for a talking therapy such as cognitive-behavioural therapy (CBT), but know the waiting list is so long it would not be helpful for someone who was struggling (some of my clients say they faced a 12-month wait for CBT on the NHS – an impossibly long time to wait if you're in a bad way).

One of the biggest problems with antidepressants, though, is that they only help with the symptoms of depression as long as you're taking them. When you stop, unless you have addressed the issues that made you depressed in the first place (like negative or overly self-critical thinking, or low self-esteem) you are likely to get depressed again. That's why all the evidence shows that combining antidepressants with psychotherapy is far more effective than the meds alone.

Research also shows that regular cardiovascular exercise is just as effective as antidepressants for mild to moderate depression. As is mindfulness-based cognitive therapy (MBCT), which is especially good at preventing relapses. Both are completely free, once you've learned how to do them, have no nasty side effects and work straight away, unlike the 2-6 week wait for the meds to take effect.

So I'm not saying you should never take antidepressants – far from it. Just that they are powerful drugs that don't help everyone, have strong side effects and should not be taken lightly. And – especially for milder forms of anxiety or mild to moderate depression – other approaches work just as well.

If you would like to book a session with me, email dan@danroberts.com

Warm wishes,

Dan

Overcoming public speaking anxiety

Public speaking anxiety is extremely common – in fact, I would say that more of us are anxious about speaking in public than not. You can think about it as a hierarchy of anxiety: speaking to one person you don't know can make you a little nervous; two, three, four, more anxious still; addressing a group of people you haven't met, a bit more difficult; giving a presentation to a small room-full of strangers, just that bit worse; then finally, way up there on the anxiety scale, giving a speech to a conference, or appearing on live TV – too hard to even contemplate for some people.

The first thing to remember is that anxiety is a perfectly normal human response to situations we find scary or threatening. It's not bad or wrong, any more than joy or sadness are. In fact, anxiety is very important – if we didn't feel anxious when, say, we walked down a dark alley at 3am, or our toddler opened up a toolbox full of sharp objects, we would fail to prevent potentially bad things from happening.

But when we get super-anxious about giving a 10-minute speech to a small room of friendly, interested people, we are clearly feeling anxiety that is disproportionate to the situation. When we get this anxious we are likely to experience a racing heartbeat, get sweaty and dry-mouthed, possibly go blank or have trouble concentrating, think lots of worrying, worst-case-scenario thoughts... no fun at all.

The good news is that this form of anxiety is treatable, either with cognitive-behaviour therapy (CBT), which is very effective for anxiety-related problems, or using self-help techniques like this one, which I often teach my clients:

Change the movie

When we get anxious about something in the future, we usually play a movie (let's call it the Scary Movie) in our heads about all the things that might go wrong – we imagine ourselves drying up and having nothing to say; forgetting our speech notes, so we have to wing it for 10 horrible minutes; other people seeing how nervous we are and judging us for it; or our audience looking bored, yawning, fidgeting and talking among themselves because our speech is so dull. Play this movie in your head enough times and, guess what? You will succeed in making yourself extremely anxious and, ironically, causing the exact problems you are worried about on the day.

So let's change the movie to... let's call it the Problem-Solving Movie. First, write down all the things you think might go wrong and find solutions for them. Worried about being dry-mouthed? Take a bottle of water with you. Worried your speech is dull? Read it to a colleague and ask for constructive criticism. Worried about appearing worried? Practice deep breathing to calm yourself down before and during the speech.

Then play this new movie every day in your head, in which everything goes well – you solve any little problems that come up, imagine everyone looking interested and engaged, giving you a big round of applause at the end, then see yourself looking proud and happy after the speech. The more detail you can include the better, especially about how things look/feel/sound, because then your brain will believe it's actually real and has already happened (our brains have exactly the same response to imagery like this and real-life experiences). This will help you feel less anxious on the day. Incidentally, this technique also works really well for driving tests, first dates, meeting in-laws, job interviews...

If you would like some help with your public speaking problems, email dan@danroberts.com

Warm wishes,

Dan

Five common myths about cognitive therapy

In some ways, cognitive therapy is the victim of its own success. Since it was developed by Aaron Beck in the 60s, cognitive therapy (also known as cognitive behaviour therapy, or CBT) has become the dominant form of 'talking therapy' in numerous countries around the world, including the US and UK. This is mainly because it works so well – research consistently shows CBT to be the most effective form of therapy we currently have. But it's also about economics – the NHS has embraced it partly because it's cost-effective too. Many problems can be resolved in under 20 sessions, some (such as phobias) in five or six.

However, as I explain below, this is not how Beck intended cognitive therapy to be practised. His initial therapy model was a 20-session treatment for depression, which I think is about right for most people. I strongly disagree with the (financially-driven) short-term treatments many people receive on the NHS for anxiety, depression and other serious psychological problems. This is just one of the myths I try to bust with my clients, and when I am teaching cognitive therapy to students. Here are some more:

1. CBT is all about filling in forms

Not true. Although some CBT techniques do involve written work for clients (such as daily thought records), good cognitive therapy is based on the relationship between therapist and client. This should be warm, trusting and supportive, as with other approaches to counselling and psychotherapy. And many of the techniques I and other cognitive therapists use involve stories, metaphors, working with imagery, role-playing, mindfulness-based techniques, drawing, Gestalt-style 'empty-chair' work... none of which involve forms!

2. CBT is a short-term, quick-fix approach

Nope. In my own practice, I always tell people that there is no such thing as a quick fix for complex, highly sensitive problems; so our work will be slow and incremental. A few problems – especially 'specific phobias' – can be resolved quickly. Most others take time – somewhere between 10 and 20 sessions, in my experience; while deep-rooted, hard-to-shift problems might take a year or more.

3. Feelings are not important in cognitive therapy

Ironically, cognitive therapy is all about emotions. Despite the name (cognitions being all of the thoughts, values, beliefs, memories, etc that make up our minds) we only focus on changing unhelpful thinking because that has a powerful impact on feelings and moods. Nobody comes to therapy saying 'I want to think more rationally'! They come because they are hurting in some way; my job is to help them feel better on a consistent, long-lasting basis.

4. Cognitive therapy is all about positive thinking

A common myth, this one. In fact, cognitive therapy is all about rational, realistic, balanced thinking, which is not necessarily positive. If you are in a horrible job or relationship, thinking positively about it would be both impossible and unrealistic. Someone once said that cognitive therapy is all about seeing things as they really are. Life is full of pain, hardship, loss, struggle... as well as joy, wonder, love, delight. The key is to give both equal weight, rather than focusing purely on the negative (common to both anxiety and depression, in different ways).

5. CBT only offers superficial symptom-relief

A common criticism from my non-cognitive counselling/therapy peers. It's true that CBT can help people feel better much more quickly than other approaches. That's one of the reasons it's so popular and successful. But this is only the start. If you suffer from depression, say – which has a high chance of relapse – as well as helping you feel better in the short-term, my aim is to teach you new ways of thinking and behaving which protect you from depression in the long-term. Again, we have very good evidence to back this up, as well as my own experience of staying in touch with clients after therapy ends to see how they're doing.

So, hopefully you now have a clearer idea of what cognitive therapy is and is not. If you would like to book a session, email dan@danroberts.com

Warm wishes,

Dan