Chronic anxiety is when the nervous system is ‘stuck’ or sensitised into a fight/flight/ freeze state. This can occur due to trauma, over work, excessive stimulation, chronic pain, surgery or chronic worrying. For some people, their nervous system becomes hyper sensitive and is quicker to enter the “fight/ Flight/ Freeze” than for others. This can be genetic and/ or or stem from early childhood experiences..

 

Whilst psychological therapy is extremely beneficial for learning about your individual nervous system and how to calm it down., physical interventions are also very powerful.  Here are some recommendations

 

1. Completely stop all drinks and foods with caffeine (coffee, coke, dark chocolate, green tea etc.)
2. Learn to sleep well by following sleep hygiene rules
3. Take time out each day to calm the nervous system – lying down quietly, even at least 5 – 10 minutes
4. Using a weighted eye bag has been shown to calm down a racing mind
5. Whilst walking around the house, wearing a heated weighted shoulder/ neck pillow as it too calms the nervous system
6. If possible, undertaking 30 minutes of exercise 4 times a week that exerts the lungs and heart (running, up hill walking, cycling, lifting weights) so you feel breathless. This ‘burns off’ stress hormones.

These are positions that you lie in , for extended periods of time. The positions change the blood flow in our body and are known to calm the nervous system and activate the rest and relaxation response. These can be undertaken each day, for 5 – 10 minutes.

 

Restorative positions have been identified to activate the calming part of the nervous system. They also increase blood blow to areas of tension and allow fresh oxygen to circulate deep within problematic areas of the body for example, neck and back for migraines, stomach and gut for Crohn’s disease, ovaries for fertility/menstruation.

 

• Use different cushions to support your body during the positions
• Use a weighted eye bag to calm a busy mind
• Try wearing headphones and listening to a meditation ap

There are an abundance of incredible calming aps that can be listened to during your 10 mins restorative yoga break, or before bedtime, or when you first arrive from from work and are taking 10 minute out before your evening starts.

 

Here are some examples:

 

• Breathing Zone – Used in the NHS with trauma patients
• Paced Breathing – sets breathing to a slow, regulated level which increases the relaxation response
• Andrew Johnson – Relax lite (hypnotherapist – this ap is free).
• Andrew Johnson – Deep Relaxation/ Deep sleep
• Relax Melodies – They have relaxing sounds that can be mixed together, plus a guided meditation

 

During your therapy sessions we can talk more in depth about what strategies are most suitable for you to find calmness, how to do them and how often.

How does it work?

Eye movements, similar to those during REM sleep, will be recreated by asking you to watch the therapist’s finger moving backwards and forwards across your visual field, while you recall the painful memory. This utilises the bodies natural ability to process painful memories, mimicking the natural healing process of REM sleep. This approach can also be used with tappers or sound, to achieve a bilateral stimulation.

 

There is also more information to be found at the UK and Ireland EMDR Association https://emdrassociation.org.uk/.

 

Please watch the below video for more information. It has been produced by the Europe EMDR Association.

Therapy for children looks very different to therapy for adolescents and adults. Children are significantly influenced by their surroundings. With younger children the approach is to work with the family as they have the biggest impact at this stage of life, especially if the child is under 12. The type of therapy is also dependent on the child’s problem and the cause of this problem.

 

For example, Cognitive Behavioural Therapy is helpful for children with anxiety and depression. However a skilled therapist will also look for other causes. It could be trauma, loss, underlying illness or an undiagnosed neurodevelopmental issue that could be underpinning their difficulties.

In our Practice we only place child clients with a therapist who has specific training in child therapy, often being previously employed in a NHS Child and Adolescent Mental Health Team  (CAMHS). They will take a thorough assessment of what led to the problem, and then choose the most helpful treatment approach.

 

For example, it is not helpful to treat a child using CBT for anxiety when the cause is trauma, as this needs a different approach… or maybe the child’s behaviour is related to grief due to changes in family circumstances – thus an approach of Systemic Family Therapy or a grief and loss model would be most useful. Narrative Therapy is also commonly used with children as it draws on stories (in a playful way), to define and change a persons understanding of difficulties and how to overcome them.

 

For example, the narrative of “worries” could be externalised and turned into the “Mr Worry”. This enables a child to understand difficult ideas of emotional wellbeing by helping them think of Mr Worry as a person who comes into their mind. The child is then taught tools of emotional resilience to make My Worry smaller in their head (i.e. distraction, breathing regulation, gentle exposure).

 

Thus different methods can be used in therapy regarding the child’s age, their development and their problem. Other approaches use art, play, drawing or reading stories. The Therapist will also use board games to build rapport during the session.

A few examples of how therapy can help children include coping with everyday worries such as school stress, and relationship issues with friends, family members and teachers. Therapy can also help with managing bullies, loss, grief, depression and anxiety and managing learning difficulties.. to name a few.

 

Therapy for children often includes working closely with carers and thus systemic family intervention is an important approach. This is where conflict, concerns and difficulties within the family are addressed by involving different family members in the therapy, so the young person and their family can move towards a place of understanding, strength and resourcefulness.

 

Areas specifically treated include:

• Parenting strategies
• Bedtime or sleeping difficulties
• Nightmares, night terrors
• Difficulties with eating
• Anger & behavioural issues
• ADHD behavioural/ emotional support
• Encopresis/ enuresis concerns (soiling/ wetting)
• General anxiety or anxiety at separations
• Difficulties with siblings or new baby
• Panic, phobias, OCD, specific traumas
• Self harming behaviours, risky behaviours
• Attachment difficulties, struggles in relationships
• Navigating family separation, change, divorce
• Low mood, depression, sadness, grief, loss, low self esteem
• Problems with friends, school, relationships, social issues
• Bullying, abuse (sexual, emotional, physical)
• Assertiveness, skills in building relationships
• Concerns about developmental difficulties
• Systemic family approaches to improve family communication
• Post natal depression and birth trauma  (adult therapy)

An important factor in child and adolescent therapy is play. It is not appropriate to expect a child to sit, and be able to talk about their fear and worries clearly. This is difficult for many adults!

 

Our child therapists are trained to facilitate communication through play. This can include using sand trays, toy miniatures, drawing, board games and cards.

Providing clinical supervision is a very important part of the work we do at Malvern Hills Private Practice. Supportive and thoughtful supervision can enable a therapist to reach their fullest potential and is the foundation for providing good therapy. Dr Abigail Pamich, Clinical Director and Clinical Psychologist,  provides clinical supervision by the hour over Skype, Telephone or Face to Face. She adheres to the supervision model of Compassion Focused Therapy – that we learn best when we feel safe, valued and connected.

Are you struggling to fall asleep? Or maybe waking up repeatedly at night? Or sleeping for 8 hours but still feel unrefreshed?

 

You may be struggling with a sleep disorder, defined as a “medical disorder of a persons sleep pattern”.  Sleep disorders are serious as they can interfere with daily functioning, increase low mood anxiety and irritability.

 

There are different types of sleep disorders for example insomnia (chronic difficulty falling asleep or maintaining sleep) sleep apnea, nightmares, night terrors, circadian rhythm disorders and many more. 

 

Insomnia is a frequent difficulty we see in our practice. In the UK 1 in every 3 people in the UK are affected.

Some of the symptoms of insomnia are:

 

• find it difficult to fall asleep
• lie awake for long periods at night
• wake up several times during the night
• wake up early in the morning and not be able to get back to sleep
• not feel refreshed when you get up
• find it hard to nap during the day, despite feeling tired
• feel tired and irritable during the day and have difficulty concentrating

Many people get insomnia on occasion without serious consequences. However for some people the problem can last for months or even years.

Persistent insomnia can have a significant impact on your quality of life. It can limit what you’re able to do during the day, affect your mood, and lead to relationship problems with friends, family and colleagues.

 

Psychological intervention can be very helpful in identifying and removing triggers for poor sleep. Sleep Hygiene is a whole approach to managing sleep concerns and utilised alongside psychotherapy been shown to help sleep disorders.

 

Another example are night terrors or nightmares. Often nightmares are intrusive material that is unprocessed in the conscious. Specific therapies called “nightmare re-scripting” are extremely helpful in reducing and stopping nightmares.

 

Night terrors are neurologically driven and certain behavioural techniques are very helpful in reducing their occurrence.

 

If you would like to know more about the treatment of sleep difficulties with psychological approaches please book a free telephone consult with Dr Abigail using the online diary.

Therapy has been shown to be extremely effective in helping people heal from trauma.

 

In our service, we specialise in treating trauma of all kinds. We work with major trauma and PTSD. We also work with more commonplace traumas such as bullying, divorce, death, family breakdown, relationship hurts, abuse, neglect, trauma arising from medical treatment etc.