Anxiety is an emotional response to something fearful: a fear that something bad is going to happen and you won’t be able to cope. Symptoms may involve racing heartbeat, sweating, rapid breathing, blushing - typical of the 'fight or flight' response.  It can be triggered by many different situations and a common but unhelpful strategy is to avoid such situations. But that can be very restricting, and anyway you can't always anticipate when you may be faced with an anxiety-provoking situation.  

Anxiety covers a wider range of issues, from social anxiety (e.g. public speaking, meeting new people, job interviews), exam anxiety, performance anxiety (sport, sex), fears and phobias (e.g. fear of heights, flying, animals) to generalised anxiety disorder (GAD) - worry and worry about worry (e.g. hypochondria); eco-anxiety (worry about the state of the planet, climate crisis, biodiversity extinction etc and sense of helplessness/hopelessness) - and panic attacks/panic disorder (often a fear of something more serious like a heart attack or unable to breath).

Mindfulness, relaxation skills training and desensitisation using imaginal exposure - with and without hypnosis - are common and proven cognitive behavioural techniques I use to treat anxiety and panic attacks.  Panic attacks can often be treated surprisingly easily once you understand how they work.  I find CBH (including Acceptance and Commitment Therapy - ACT - techniques) can be especially helpful in addressing the challenges associated with ADD/ADHD (attention deficit disorder/attention deficit hyperactivity disorder), e.g. difficulty focusing attention, disorganisation and procrastination; and for anxiety and worry around academic deadlines/exams or key milestones, or fears about the future generally. e.g. careers, or the consequences of environmental degradation and climate change.

See blog posts on Social anxiety, Procrastination, Eco-anxiety and Celebrating uncertainty

Stress is typically the result of our appraisal of something that causes us stress (a stressor), such as work load - or our work/work place itself - interaction with others, or life events (such as bereavement, loss or change of job) - as both something negative and with which we are unable to cope.  So it is not so much the event or action that causes us stress as the way we interpret it as being something outside our control and that will have an adverse effect upon us. 

Some simple questions to ask yourself, to see if you are suffering from stress, are:

• Do you frequently bring work home at night?

• Do you feel there aren't enough hours in the day to do all the things you must do?

• Do you feel tired even though you've had adequate sleep, or are you having sleep problems?

• Do you find yourself thinking about work or problems when you are meant to be relaxing?

• Do you get irritated or angry easily, or have mood swings?

• Do you find you are depending more on alcohol, caffeine, nicotine or drugs?

• Do you have an increase in muscular aches and pains, e.g. in the neck, head, shoulders, lower back?

• Do you have little time for interests outside of work?

If you've answered yes to several or more of these then you may be suffering from stress and it would make sense to seek help.

Worry is often a consequence and a symptom of stress - worrying about the future, or ruminating about the past, or about work load or work/life balance, or relationships - often characterised by negative 'storytelling'.  What am I going to do for a future career? How can I change my career/job? Why did I do this course? How am I going to get everything done in time? Why can't others in the group/team do their fair share of work? Worry itself is an unhelpful coping strategy as we seek randomly for solutions to the cause of our stress. That in turn can lead to poor sleep (insomnia), tiredness and more worry. And anxiety is a common emotional response to stress and stressful situations. I can help you understand the causes of stress and your response to stress, and give you the tools to help remove it and develop lasting resilience to future stressful situations.

And see my blog post on Worry - what is it and how to deal with it?

See also Work stress / career change below.

Low self-worth - or low self-esteem - can lead to depression and anxiety and may involve a lack of assertiveness and/or poor problem solving.  On arriving at university or your work place you may feel as though you are an 'impostor' - out of your depth - and that others are so much better than you, though actually many others are thinking the same.  Or you may feel 'different' or lonely or find yourself having to deal with a change of culture and attitudes from those you've been used to.  At the root of all this are often unconscious 'thinking errors', developed over time, often as coping strategies that in the end serve to reinforce a problem rather than solve it.  I can help you understand what is going on, and provide you with the means to change often long-established unhelpful patterns of behaviour and thinking.

Do you seek the approval of others, lacking confidence in your own ability to make decisions or express yourself?  Do you question your own sense of self - who you are, or maybe you are only now discovering more about your sexuality, for example? A series of vicious cycles can become established over time that reinforce your sense of low self-worth (e.g. only feeling good about yourself if praised by others), leading to periods of low mood or much deeper depression. But learning to trust yourself, and to become more in control of your feelings, thoughts and behaviours can turn things around completely and build confidence in yourself. An evaluation of your personal values - what’s important to you in life (and how study or work interfaces with other aspects of life) can be a critical starting point. Cognitive awareness (being aware of your thoughts for what they are), mindfulness, relaxation, assertiveness and problem solving techniques can all help provide you with the means to change.  Self-hypnosis can help build your confidence further.

And see my blog article on ‘Unwritten rules - I should, I must, I need…’

Perfectionism is a common issue among students in particular (but staff are far from immune), and one that is ideally suited to cognitive behavioural hypnotherapy.  I can help you understand what is going on and give you the tools and techniques to look at things in a different way.  Perfectionism can be debilitating, but is also resolvable.  It may manifest itself as procrastination, for example, or excessive planning, and preferring not to do anything if you can't do it perfectly. But, being perfect simply isn't possible, however hard you try (we are all human after all), and making mistakes is the way we actually learn.  Finding ways to accept that is liberating, so you can enjoy the learning process instead of focusing only on the outcomes.

Perfectionism both causes anxiety and is the result of anxiety - it is a coping strategy - albeit one that over time has become unhelpful. Trying to be perfect is the way you might seek to cope with the anxiety you experience from exams or coursework deadlines.  It can also be the result of faulty thinking - that everything depends on doing not just well, but by being the best.  But perfectionism can affect all aspects of your life, not just work - from how you approach every day issues/problems to your relationships with others. I can help you re-think and re-appraise your whole attitude and to your way of living and working, and so free yourself from the debilitating effects of always seeking perfection.

See blog post: Perfectionism - the modern scourge?

Do you have trouble getting off to sleep at night, lying awake seemingly for hours without dropping off? Or wake up during the night and can't get back to sleep? Does your mind race with thoughts about the day just gone or worry about the future?  Do you feel rubbish during the day because of poor sleep the night before? If you have a sense of having slept badly and suffer as a result then you probably have insomnia. Insomnia is a lot more common than you might think - around 35% of people report having sleep problems in any one year.  CBT and CBH are especially well suited therapies for dealing with insomnia because they start from seeking to understand what is going on emotionally, behaviourally and cognitively (conceptualisation) and then target the causes(s) of insomnia and why it is being maintained as a problem, giving you practical ways in which you can address the problem and the consequences.

While insomnia is often linked with anxiety, stress, worry, low mood or depression, that is not always the case - it can become almost habitual and something you put up with because you have been unable to resolve it.  Yet CBH offers a wide range of behavioural, cognitive and hypnotherapeutic techniques to treat insomnia with a very strong evidence base for their effectiveness (70-80% showing improvement as a result of treatment), including mindfulness, relaxation techniques, behavioural strategies, cognitive restructuring, sleep hygiene and self-hypnosis.  Insomnia doesn't have to be a way of life - you can get help.

A word of caution if you are using a sleep app — apps may help , but also they can lead to an obsession with measuring and monitoring so-called ‘sleep quality’, to the extent that you may end up with a problem when you never actually had one before, or else make a mild issue worse! If you are obsessed by your sleep quality, ditch the app!

See blog post on Insomnia

Pain - for example from sports' injury, muscle and back pain, post-operative pain - is a subjective experience and so it is not surprising that there is strong empirical evidence for the use of cognitive behavioural hypnotherapeutic techniques for managing chronic and even acute pain.  We interpret pain in similar ways to the way we experience other events, through our beliefs and assumptions built up over time, hence different people will experience the same stimulus differently, some able to tolerate a level of pain that others find unbearable. Our thoughts, feelings and behaviour that accompany the experience of pain influence our ability to cope with it and the significance we afford it.  Muscle tension, for example, exacerbates the experience of pain - typically when we are in pain we tense our muscles, but this in turn enhances anxious thoughts and fears about what the pain means.  See blog post on Tension and anxiety.

The cause of pain should always be checked out first by a doctor, but some pain cannot be adequately controlled with pain killers or residual pain may remain. Mindfulness, relaxation and self-hypnosis can help you gain control and manage chronic residual pain, reducing the importance it assumes in your life.  

Anger is another common negative emotion, and many people have found themselves experiencing anger and frustration during the Covid-19 Pandemic. Locked-down with a partner or family, or flat-mates, unable to go about the normal routine outside the home has created inevitable tensions amongst individuals and groups.

Anger can be thought of as the ‘fight’ part of the ‘fight or flight' response - the normal physiological response to something fearful. We may feel defensive when seemingly under attack. We may be more tetchy with other, sensitive to criticism, believing our thoughts about what others may be thinking. Tension in the body goes through the roof. And our coping strategies may just make that worse, e.g. using alcohol as a way of numbing underlying fear or worry or sadness, which in turn may remove inhibitions that allow anger to show more readily.

And circumstances can disrupt normal routines; Covid-19 lock-down, for example, often meant living 24/7 with others in the same home, in a way that was never experienced before. Previously you had different routines, often doing things on your own or with others (colleagues, work mates etc) during the day. You had other things to talk about; and could enjoy spending time together doing things together you chose to do.

Many of the techniques I use are similar to those used for stress and anxiety - they are after all closely related emotions. Relaxation, slowing things down and other behavioural changes can be key, as well as understanding the role of thoughts, of negative stories we tell ourselves about the past and the future.

See blog posts on Tension and Covid-19

As with other forms of anxiety, eco-anxiety (or climate anxiety) is an emotional response to something fearful: a fear that something bad is going to happen and you won’t be able to cope. In this case, worry about the state of the planet, climate crisis, biodiversity extinction etc and an overwhelming sense of helplessness/hopelessness. Sometimes this might involve panic attacks, anger or overwhelming sadness and depression (eco-distress), an avoidance of going outside or doing the things you enjoy doing.

Eco-anxiety/eco-distress may be something that comes and goes; it may be triggered especially by a period of hot, cold or wet weather, perceived signs of climate stress or news items (e.g. forest fires, deforestation, politicians who don’t care) that draw you in to more worry and anxiety or depression. It can have a profound effect upon your sense of well-being now and into the future - do you want to have children, for example - what future might they have, and what impact on the planet?

Because the environment has found a special place in your personal values, I find Acceptance and Commitment Therapy (ACT) and mindfulness approaches can be very effective for eco-anxiety and eco-distress, as can meta-cognitive approaches - understanding any beliefs about beliefs; thoughts about thoughts. But my 35 years working in the environmental field (as an academic, consultant and campaigner) means I am well placed to specialise as a therapist in this aspect of anxiety and distress - I get the ‘environment’, as well as how this can impact the individual. A wide range of cognitive and behavioural techniques can be utilised and enhanced with hypnosis to help change the mindset so that the environment remains an important part of your values, but no longer distorts everything else. A more hopeful outlook can begin to grow.

I offer individual one-to-one therapy, online workshops and also small-group therapy for eco-anxiety. See my blog for details of the next online Eco-anxiety Workshop (likely now to be in the first half of 2024) or contact me directly for more information.

See blog posts on Eco-anxiety

Testimonial:

Work can be a significant cause of stress, often resulting in negative emotional responses and behavioural coping strategies that may not always be helpful. It may not necessarily be a specific event or action that causes us stress as the way we interpret such events or situations as being something outside our control and that will have an adverse effect upon us. Stress is a process that involves a trigger (or stressor) and our cognitive, emotional and behavioural responses to it. Working from home and/or hybrid working can be a positive and a negative way of working: positive in that it can remove other stressors like commuting from your day to day experience; negative in that routine may be removed and work and home-life boundaries become increasingly blurred. It becomes ever more difficult to switch off, create boundaries and let go of work, and the social connection with people in real life diminishes. But there are ways to manage these things more effectively, to be able to relax and regain perspective; I can help you with that.

There are times, however, when a career change is an appropriate and sensible option for dealing with work stress, where the stress and your responses are telling you something - that there must be more to life than this. Sometimes the work environment is so intolerable that no amount of stress management can change the way you respond; the environment has become too toxic to tolerate, or else you realise your values and interests lie elsewhere. How to go about a career change or job move can seem daunting, but with support a process can be established that helps gain perspective and confidence in your ability to make a move.

I spent 10 years while in academia as a departmental careers advisor, so have many years’ experience helping individuals with career planning as well as my own diverse experience in the public, private and voluntary sectors. I also often draw on Acceptance and Commitment Therapy (ACT) as an approach for dealing with work stress and career change since it involves a reflection on your own personal values at a particular moment in time - on what’s important to you in life - and how those values can become distorted when work issues dominate in an unhelpful way.

See also Maybe I need to change my job blog post.