Anxiety and Panic
Going over and over something in your mind
Unable to push unwanted thoughts away
Unable to settle
Difficulties with sleep
Feeling on edge, restless, unable to concentrate
Tightness in your chest
Having an uneasy feeling that something is wrong
Severe anxiety symptoms / Panic Attack
A panic attack will pass. Most panic attacks last between five and twenty minutes. They are not dangerous but can feel very frightening and overwhelming at the time. Your heart is probably pumping fast and you feel light headed, dizzy and faint. You may be shaky and trembling with difficulty breathing. You could feel sweaty and cold at the same time. You might be afraid of losing control, going mad or dying.
Understanding Anxiety Symptoms
When we are in sudden danger our muscles need to work quickly and effectively so that we can freeze, fight or run. Straight away our bodies release hormones into the blood stream. Adrenaline is the main hormone, causing various changes in our bodies, hence the symptoms above.
During a panic attack your body and mind is reacting as if you were in immediate danger, although anxiety is usually related to ongoing stresses, worries and fears in our lives
If you have experienced very frightening symptoms, being afraid of having them again is understandable. For some people this becomes the focal point of their anxiety. You might be afraid of experiencing a panic attack and / or worried about how other people will react if they see you in a state of anxiety.
How you can help yourself during a panic attack
Slow your breathing down if it has become fast and shallow.
Slowly take in deep breaths through your nose and release them slowly through your mouth.
Keep repeating to yourself 'its okay' or any other phrase which you find soothing
How counselling can help
Your symptoms may start to ease as you describe them to your counsellor, even if what you are experiencing is quite vague and difficult to articulate. Giving yourself this attention and being listened to attentively can bring great relief.
By talking about your fears and anxieties, perhaps several times, you can put them into perspective until they become less overwhelming and more manageable.
You can work with underlying causes of your anxiety. These may stem from past and / or recent experiences.
You may be able to learn more about your anxiety by getting a sense of how it feels in your body. For example there might be a restless feeling in your legs. If you can stay with that feeling something else might emerge. Perhaps you become aware of wanting to run away from something.
You can also work with feelings that are associated with anxiety such as fear, shame and feeling powerless.
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Counselling for Trauma
Psychological trauma is a reaction to a traumatic event. That is any incident which is perceived as being dangerous or life threatening. Post Traumatic Stress Disorder begins after the event, sometimes immediately and sometimes days, weeks or months later.
Certain traumatic events are obvious threats to our well being for example being attacked in the street, whilst others are seemingly benign for example a child having an operation for their own good. What matters is how the event is experienced by the individual concerned.
Traumatic events that can trigger PTSD - Post Traumatic Stress Disorder.
Experiencing PTSD - Post Traumatic Stress Disorder
Soon after the event has occurred the PTSD sufferer may feel numb and experience a sense of unreality, perhaps a feeling of walking around in a dream. This is a natural way of coping with trauma. It reduces the immediacy of whatever has happened, giving time to come to terms with it more gradually.
Commonly the sufferer has flashbacks, remembering the event and experiencing it again as if it were happening now. There may be nightmares and fears of falling asleep in case the nightmares reoccur.
There might be a sense of needing to be continuously on guard, even although the immediate danger has passed. This can be mentally tiring, making it difficult to relax and to fall asleep.
Some people feel guilty. Perhaps because they survived and others perished, perhaps because they have a sense of responsibility for whatever happened or maybe in retrospect they believe that there is something that they could have done to change the situation.
Sufferers might find themselves reliving their trauma and they can be disturbed by intrusive thoughts. As a result trauma sufferers may be preoccupied and unable to concentrate upon anything or anyone else. They may lose interest in others and in everyday life. Sufferers who are not sleeping well can be tired and irritable. The symptoms of Post Traumatic Stress can affect work, study and relationships.
One way of dealing with trauma is to try and block out what happened by keeping busy with work and hobbies and avoiding anything which might trigger memories such as certain places and people. Sufferers might isolate themselves from family and friends who could then feel excluded.
Physical symptoms of Post Traumatic Stress Disorder include stomach upsets, aches and pains, headaches and the effects of not having sufficient sleep.
Counselling for PTSD - Post Traumatic Stress Disorder
Talking about what happened can bring some relief and clients may need to do this over and over again. Professional counsellors are prepared to listen as many times as is necessary. Counsellors and psychotherapists in Britain are required to have professional supervision which enables them to deal with their own reactions to hearing about traumatic incidents.
During counselling clients can work with any uncomfortable feelings which are now affecting them including guilt and anger. They can begin to make some sense of what happened and how they might come to terms with it.
Bereavement counselling might be needed. For example victims of torture may have also witnessed the death of family members and friends. Clients who have experienced trauma are often more aware of their own mortality and may want to work with associated feelings and fears.
Trauma can affect the sufferer’s sense of safety. Some people find that they have become nervous and jumpy. Depending upon the incident sufferers may now be wary or frightened of strangers and afraid of everyday activities such as using public transport and crossing a road. This can be experienced as a loss of self or a change in personality the client is no longer the person who used to freely go about their daily life. Counselling can support the client in regaining a sense of self and in becoming more trusting and confident.
National Center for PTSD www.ptsd.va.gov
I Can’t Get Over It: A Handbook for Trauma Survivors by A Matsakis (1996)2nd Ed. New Harbinger Publications
Waking the Tiger: Healing Trauma by P.A Levine (1997) California: North Atlantic Books
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Counselling for Abuse
Types of Abuse
Childhood abuse can be physical, emotional, or both.
Children who are not given adequate food, warmth, clean clothes and medical attention are probably suffering physical neglect.
Children who are not loved, cuddled and spoken to with kindness, warmth and affection are probably suffering emotional neglect.
Children who are not given a suitable education that meets their abilities and needs are probably being neglected educationally.
Physical Abuse is to do with causing physical harm.
Emotional abuse can include bullying, offensive language, and remarks that are insulting and belittling, negatively affecting confidence and self-esteem.
Child sexual abuse includes sexual contact, being exposed to pornography, and being used to take pornographic photographs.
Effects of childhood abuse
Childhood abuse can cause physical and emotional harm.
Children often believe that they are to blame and feel guilty and ashamed. Sleep can be affected and once asleep children may have nightmares relating to the abuse.
Abused children can suffer educationally, for example by missing school due to neglect and physical symptoms. Abuse and fear of abuse can make learning and concentrating upon school work difficult.
Abused children may be afraid of disclosing the abuse to a responsible adult, assuming that they will not be believed and that telling someone will make their situation worse. As a result they can feel lonely, isolated, different from their peers and burdened by the secrets that they are keeping.
Counselling adults who suffered childhood abuse
Adults can continue to suffer the effects of childhood abuse. Counselling offers a safe space to talk about your experiences in your own way and at your own pace.
I find that person- centred counselling helps clients to feel more at ease because it is an empathic approach. I am interested in understanding what this is like for you from your point of view, without judging or blaming you for anything that has happened. With time you may find it easier to believe that it was not your fault.
Just talking to a professional counsellor can be a relief. It is an opportunity to acknowledge your suffering and to let go of any secrets that you are holding, in a warm and supportive environment.
During counselling sessions you might want to explore your current relationships and how abuse has affected them. Abusers are often family members and it may be helpful to consider these relationships now as an adult.
Other areas which we can work with include confidence and self-esteem, depression, anger, fears, self harm, addictions, eating disorders and suicidal feelings.
You may find that counselling helps you to heal and to move forward in your life.
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Dissociative Identity Disorder (DID) / Multiple Personality.
Most of us dissociate from time to time, we may become lost in thought or gaze dreamily into space. Dissociation is an altered state of consciousness that separates us from our feelings. In life threatening circumstances such as fire dissociating can help us to save lives by acting automatically without becoming overwhelmed with fear.
Children who are experiencing trauma such as sexual abuse may protect themselves from intense emotional and physical pain by dissociating, for example by imagining that they are somewhere else. They might lose touch with reality to the extent that later they do not remember the abuse. Children who are repeatedly abused can eventually dissociate automatically.
Under extreme stress from abusers, with no power to escape and no one to save or soothe them, some children create alternative identities, known as alters to help them cope. This is the best that they can do in the situation.
Alters all have their own functions for example holding the memories of a traumatic incident and keeping the memories out of conscious awareness. When there is a trigger a particular ‘alter’ may take over. For example a strong boy alter might deal with a perceived threat.
Each alter is an element of the same person known as the host. The host may not be aware of having alters although alters might know about each other.
Living with Dissociative Identity Disorder (DID)
The experience of Dissociative Identity Disorder (DID) varies from person to person. If you have DID the following may be familiar:
Time loss and blackouts
You would not choose to wear some of the clothes in your wardrobe – they belong to ‘someone else’.
Some things, such as a particular colour terrify you although you do not know why.
You have flashbacks and nightmares.
Depression, mood swings, anxiety, panic attacks, difficulties with eating and food, self harm, drug and alcohol abuse
Sometimes you are suicidal.
You do not like to be touched / have problems with sexual intercourse.
You have hallucinations, headaches and physical symptoms that seem to have no cause.
You try to appear the same as everyone else and often achieve this when necessary e.g. whilst at work.
Your symptoms have been misdiagnosed more than once.
Counselling for Dissociative Identity Disorder (DID)
A consistent and supportive therapy relationship with clear boundaries is often healing. Therapy may continue over several years as the sufferer discovers memories that have been buried away.
Clients can work with emotions such as anger, fear and shame and the feelings of powerlessness and loss of control that childhood abuse can cause. Releasing their emotions can reduce the client’s stress and might help with problems such as headaches, insomnia and panic.
During counselling sessions people with Dissociative Identity Disorder can also work with the social and practical effects of living with DID, for example maintaining friendships and holding down a job.
Some clients with DID work towards integrating each alter within themselves to function as a single person. Other clients prefer to live their lives more harmoniously whilst continuing to have alters. Integration is generally a long process. There can be feelings of loss and loneliness in losing alters who have their own personalities and who have been companions to the host for most of their life.
Childhood abuse is extremely disempowering, children have no say and no power to change their situation. In contrast I see counselling as an opportunity for clients to develop self-trust, enabling them to make their own decisions.
I therefore believe that whether or not to integrate should be the client’s choice and that if chosen, integration needs to proceed at the client’s pace.
PODS - Positive Outcomes for Dissociative Survivors www.pods-online.org.uk/
Today I'm Alice by Alice Jameson (2009) Sidgwick & Jackson
A Fractured Mind by Robert Oxnam (2005) Hyperion
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The Person-Centred Approach
Person-Centred counsellors respect their clients' wisdom and self-understanding, they trust them to explore areas of importance and to lead sessions at their own pace.
It is the client who knows what hurts, what directions to go, what problems are crucial, what experiences have been deeply buried. Rogers, 1961
Central the approach is the belief that people have a natural tendency to develop psychologically when they are in an accepting, empathic and genuine relationship.
This is a healing relationship that relies upon personal qualities in the counsellor. For many practitioners, developing these qualities within them self is a continuous process.
The core conditions
Unconditional Positive Regard is also known as acceptance. Counsellors are genuinely accepting, respectful and warm towards their clients, who can explore themselves and their issues without being judged or criticized. When people are sincerely accepted as they are, it is easier for them to accept themselves, and to have greater self esteem.
Empathy involves understanding clients at a deep level which helps them to feel less isolated and alone with their troubles. When counsellors reflect what clients are telling them, clients can hear themselves more clearly, they can look at their own views and meanings, gaining insights and self-awareness.
Congruence is also known as authenticity and genuineness. Counsellors notice what they are experiencing during sessions so that they can be honest and open in the relationship. Because they are honest and open, counsellors are trustworthy. When counsellors consider it helpful, they may share what they are experiencing with clients.
The relationship which I have found helpful is characterized by a sort of transparency on my part, in which my real feelings are evident; by an acceptance of this other person as a separate person with value in his own right; and by a deep empathic understanding which enables me to see his private world through his eyes. Rogers, 1961
The Person-Centred Approach is Empowering for Clients
Rather than giving advice or analysing, Person-Centred practitioners hold an open and supportive space. This is so that clients can find their own path and their own answers, relying upon personal resources.
In my early professional years I was asking the question: How can I treat, or cure, or change this person? Now I would phrase the question in this way: How can I provide a relationship which this person may use for his own personal growth? Rogers, 1961.
Rogers, 1961, On Becoming a Person
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Frequently Asked Questions
To arrange counselling, supervision and focusing sessions contact me by email or by phone
020 8930 9831 (home) 07941 958 034 (mobile). You are welcome to ask me questions and to discuss your needs.
How many sessions will I need?
We can discuss the number of sessions together, taking into account your needs and wishes. Since these can change over time I might suggest having a review to look at how you are feeling and to consider your next steps.
I do not know what is wrong
Sometimes we sense that something is wrong without being able to identify the problem. Maybe there is some sadness, a loss of energy, stuckness and so on. You can work with these feelings in counselling and / or Focusing sessions.
Will you expect me to do all the talking?
Our conversations are two-way. My Person-centred approach is relational which includes forming a bond and working together with the issues that you bring.
Is counselling about giving advice / information?
In my opinion and in the way that I work, counselling is about facilitating you to feel more confident about making your own decisions. If I have relevant information I am happy to share it when appropriate.
Will you provide supervision reviews?
Counselling training courses often require regular supervisory reviews. I see these as learning opportunities and I am happy to complete reviews with you.
Does supervision include support with BACP Accreditation and working in private practice?
I view BACP Accreditation and working in private practices as important aspects of supervision. I have experience in both areas and will do my best to support you.
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Paula Newman is a Focusing teacher, supervisor and counsellor in Stanmore offering daytime and evening appointments. You are most welcome to get in touch if you would like to discuss your needs or to book an appointment.