Author: Phil

There are many types of therapies carried out by mental health professionals. These are also called frameworks or modalities, but what is important is that each is an evidenced – that is, researched and proven – method of treating someone with mental health difficulties. You should always ask your therapist if they’ve had training and practice in the therapy that you’ll be engaging in.

Cognitive Behavioural Therapy, also known as CBT, is one of the most widely-known and has good evidence for all sorts of difficulties including trauma, depression, and anxiety disorders. It can also be used for difficulties in the workplace, within relationships, for people with low motivation, and for so much more.

At its core, CBT focuses on resolving two types of difficulties:

1. Vicious cycles in the present that keep us stuck in unwanted behaviours and thought pattens

2. Long-held beliefs from the past that continue to hang over us and affect how we live today

1. Vicious Cycles

Four things that we all experience can interact with each other and result in vicious cycles:

THOUGHTS      EMOTIONS      BODILY SENSATIONS      BEHAVIOURS

For example, if I’m feeling anxious about a presentation, I might worry that I’m going to be fired, which makes me tense, which then ‘tells me’ that I’ll do a bad job, so I experience nausea and avoid going to work. Or if I feel bored, my body might become lethargic and I believe that I don’t have the energy to go out so I stay in bed. Thoughts, our emotions, our physiology and our behaviours all affect one another, fusing into vicious cycles that we can become trapped in.

2. Core Beliefs, Traumas and Fears

Where do these vicious cycles come from? They might have begun following a traumatic experience or after an earlier period of rejection, neglect, or misapprehension about the world. Then we ‘see’ the world through this, usually unflattering, lens.

CBT Therapy*

Clinical Psychologists (and other therapists) trained in CBT can help you understand where these long-held unhelpful beliefs come from, whilst offering you strategies to break the vicious cycles, for example:

THOUGHTS – Can be resolved by thought-challenging exercises and trying out experiments to test whether the beliefs we have about ourselves are realistic or not.

EMOTIONS – CBT can explore why we feel unwanted emotions, such as fear, anger and sadness, and can help to normalise them and reduce their severity.

BODY – Relaxation exercises are one of the many techniques that can help us to lower the stress felt in our bodies.

BEHAVIOURS – Difficult situations can be challenged, such as through exposure to your fear or discovering new ways to engage in the world that brings meaning and satisfaction.

Next Steps

Mental health difficulties should always be treated by a qualified therapist.

I have worked with lots of people using CBT for a range of difficulties, including phobias, trauma, depression, social anxiety, OCD, moral OCD, anger, misophonia, relationship difficulties, and sexual performance problems as well as many others.

Contact Me

I offer online therapy and would love to support you too. Please contact me here for more information.

Phil

Dr Phil Lurie
Clinical Psychologist

*I know. That’s a bit like saying ‘PIN Number’

He has worked in the NHS, abroad and online with expats. He understands the issues regarding expatriate support, including culture shock, social isolation, stress, anxiety and low mood. He has also supported those with work-related issues, including social anxiety when presenting to others, bullying from colleagues/superiors, and motivational issues, for example, procrastination in the workplace and/or ambivalence about career progression.

Dr Phil is one of the few mental health professionals to specialise in Misophonia as well as Tinnitus, Hyperacusis and other sound sensitivities. Misophonia is a relatively new clinical disorder and Dr Phil can support both adults and children with the assessment, psycho-education and treatment of this condition.

Having doubts is a normal, and healthy, part of life. We often ask ourselves questions like: Am I doing a job that matters to me? Am I living somewhere that makes me happy? And one of the biggest questions that I receive in therapy: How do I know if I’m with the right partner?

People come to me for help when they’re unsure about their relationships. Sometimes there are red flags: maybe the person is abusive or you just don’t love them any more. Not every relationship should last. But what if the relationship looks good on paper and yet…

You’re. Just. Not. Sure?

Relationship OCD

Doubts, as we said, can be helpful. They allow us to check in with ourselves and make sure that we’re on the right path. Let’s imagine that we’re walking along this path and we come up to a can with the label ‘uncertainty.’ Our job, whenever we catch up to this can, is to see if we need to change course, and then kick the can far into the direction that we want to go and enjoy the walk until we meet up with it again later.

OCD (Obsessive Compulsive Disorder) is often better known as the problem that affects physical behaviours, such as checking doors are locked or obsessively cleaning. But it also keeps our thoughts racing. Those ruminating, intrusive questions that won’t let us go. For example: What if I don’t fancy this person the next time I see them? What if we don’t last? What if I’m not good enough for them? What if others don’t find this person attractive?

Relationship OCD (ROCD) is the can that we can’t kick down the road, the one that stops us from being with someone without constantly questioning whether we should. ROCD makes us seek reassurance that we’re on the right path, and it keeps us checking if we can come up with a conclusive answer.

ROCD can devastate. It can sap all the joy from the experience of dating someone. You stop being present, and you can’t enjoy intimacy without wondering if these moments are as good as they could be. You’re so busy dealing with the ‘can of uncertainty’ that you’ve stopped enjoying the view. (And let’s face it, when we’re with someone, part of the pleasure is in enjoying the view!)

Therapy

Together, in therapy, we can explore your earlier experiences and your current difficulties to help us understand why you’re struggling with ROCD. We will also introduce practical strategies to reduce your distress or resolve it entirely.

ERP – A Practical Strategy

One of the best techniques for ROCD is Exposure and Response Prevention. ERP asks you to bring to mind the anxious thought and then not fight it, the opposite of what anxiety wants you to do. For someone with germ phobia, that might mean exposing them to dirt and then remaining in that situation, even if they want to run away or wash their hands. ERP for ROCD is no different. If the brain tells us we don’t love our partner we can counter it by saying something like ‘OK, cool, maybe I don’t and I can even picture us breaking up. But today I don’t need to decide that.’

The goal of ROCD therapy isn’t necessarily to determine if we’re in the right relationship; instead it’s to train the brain to react differently in the face of anxiety. It sounds tough, and it can be, but managing ROCD is about teaching the brain that we don’t immediately ‘buy’ what it throws at us. That we’re happy to kick the can down the road for a while longer.

Next Steps

Anxiety disorders should always be treated by a qualified therapist.

I have worked with lots of people with ROCD, as well as other anxiety disorders, and have helped plenty of people to embrace committed and loving relationships, as well as to enjoy life to the full despite the creeping doubts that will, inevitably, come from time to time.

Contact Me

I offer online therapy and would love to support you too. Please contact me here for more information.

Phil

Dr Phil Lurie, Clinical Psychologist

I have created a series of handouts for improving our we–being when in social isolation. Please feel free to share this with anyone who may benefit from it

The first offers advice for managing physical well-being. Strategies include how to exercise, eat and sleep well:

Handout 1. Physical Well-Being in Social Isolation

Another handout, and an important one. It is easy to become lethargic without routine and quick to feel helpless when we lose sight of what matters to us. This handout includes advice on how to live meaningfully in social isolation:

Handout 2. Living Meaningfully in Social Isolation

I’m sure that everyone is discovering new ways to interact with others despite the lock-down, but here are a few extra ideas for how to keep socially connected during this time:

Handout 3. Social Connectivity in Social Isolation

Finally, I wrote an article about living meaningfully in social isolation for the Huffington Post, which you can access: here.

Dr Phil Lurie, Clinical Psychologist